Provider Demographics
NPI:1124871900
Name:RESNICK, ELISE M (LCMFT, PHD)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:M
Last Name:RESNICK
Suffix:
Gender:F
Credentials:LCMFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8922 COURTS WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2276
Mailing Address - Country:US
Mailing Address - Phone:240-433-7081
Mailing Address - Fax:
Practice Address - Street 1:11135 NEWPORT MILL RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1648
Practice Address - Country:US
Practice Address - Phone:240-433-7081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist