Provider Demographics
NPI:1891459202
Name:MARYLAND CHILD THERAPY SPECIALISTS, LLC
Entity type:Organization
Organization Name:MARYLAND CHILD THERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-788-4868
Mailing Address - Street 1:10 N JEFFERSON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4865
Mailing Address - Country:US
Mailing Address - Phone:301-788-4868
Mailing Address - Fax:
Practice Address - Street 1:10 N JEFFERSON ST STE 203
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4865
Practice Address - Country:US
Practice Address - Phone:301-788-4868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty