Provider Demographics
NPI:1982490454
Name:MARYLAND CENTER FOR EVIDENCE BASED THERAPY LLC
Entity type:Organization
Organization Name:MARYLAND CENTER FOR EVIDENCE BASED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:913-912-3545
Mailing Address - Street 1:14317 SHOREHAM DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-4481
Mailing Address - Country:US
Mailing Address - Phone:913-912-3545
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE STE 965
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4325
Practice Address - Country:US
Practice Address - Phone:913-912-3545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty