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NPI Code Detail

MEDICARE: SAFE SPACE FOR FAMILY HEALING

MEDICARE: SAFE SPACE FOR FAMILY HEALING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103T00000XPsychologist

General Provider Information

NPI Number : 1952170532
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFE SPACE FOR FAMILY HEALING
Provider Business Mailing Address
First Line : 507 DENNIS MAGRUDER DR
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-2110
Country : US
Telephone Number : 202-271-5593
Fax Number :
Provider Business Practice Location Address
First Line : 507 DENNIS MAGRUDER DR
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-2110
Country : US
Telephone Number : 202-271-5593
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ABENA BROWN-ELHILLALI
Credential : PH.D.
Telephone Number : 202-271-5593
Provider Enumeration Date : 12/25/2023
Last Update Date : 12/25/2023

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Directions to “SAFE SPACE FOR FAMILY HEALING ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.