# INNOVATIVE THERAPEUTIC SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003147505
- **Authorized official:** MISTY CROMARTIE LCPC (CEO)
- **Authorized official phone:** (301) 455-7872

## Contact information

- **Practice address:** 14440 CHERRY LANE CT, SUITE 208, LAUREL, MD 20707-4946
- **Practice address phone:** (301) 604-1458
- **Mailing address:** 14440 CHERRY LANE CT, SUITE 208, LAUREL, MD 20707-4946
- **Mailing address phone:** (301) 604-1458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LC1655 | MD | — |
| 101YM0800X | Mental Health Counselor | LC3403 | MD | Yes |
| 1041C0700X | Clinical Social Worker | 15169 | MD | — |

## Other

- **Enumeration date:** 01/22/2010
- **Last updated:** 03/09/2012