Provider Demographics
NPI:1992092654
Name:LITTLE LEAVES BEHAVIOR THERAPIES
Entity type:Organization
Organization Name:LITTLE LEAVES BEHAVIOR THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-390-0120
Mailing Address - Street 1:9545 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1438
Mailing Address - Country:US
Mailing Address - Phone:202-420-8359
Mailing Address - Fax:202-318-2351
Practice Address - Street 1:9545 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1438
Practice Address - Country:US
Practice Address - Phone:202-420-8359
Practice Address - Fax:202-318-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1-03-1325103K00000X
MD4416103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty