# INSTITUTE FOR BEHAVIORAL CHANGE, INC.

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

## Provider details

- **NPI number:** 1124298484
- **Authorized official:** DR. HOWARD MABRY PHD (CEO)
- **Authorized official phone:** (301) 818-0110

## Contact information

- **Practice address:** 2670 CRAIN HWY STE 205, WALDORF, MD 20601-2816
- **Practice address phone:** (301) 818-0092
- **Practice address fax:** (301) 818-0110
- **Mailing address:** 2670 CRAIN HWY STE 205, WALDORF, MD 20601-2816
- **Mailing address phone:** (301) 818-0092
- **Mailing address fax:** (301) 818-0110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 103000A-DT-Y-068 | DC | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 1652 | DC | Yes |
| 1041C0700X | Clinical Social Worker | LC301420 | DC | — |

## Other

- **Enumeration date:** 03/03/2008
- **Last updated:** 03/22/2023