MEDICARE: OPEN DOOR PSYCHIATRIC ASSOCIATES, LLC

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
1	103TC0700X	Clinical Psychologist	04376	MD

General Provider Information

NPI Number	:	1952823445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN DOOR PSYCHIATRIC ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	5906 BEECH AVE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3423
Country	:	US
Telephone Number	:	240-630-2220
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 DECATUR AVE STE 1
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2148
Country	:	US
Telephone Number	:	240-630-2220
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. BITHIAH RAE REED
Credential	:	PHD, ABPP, MSCP
Telephone Number	:	240-630-2220

Provider Enumeration Date	:	07/17/2017
Last Update Date	:	07/17/2017

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