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Organization
WILLOW OAK THERAPY CENTER, INC.
Active
Organization
WILLOW OAK THERAPY CENTER, INC.
Active
Other names
Affiliated Community Counselors, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JODY TABNER THAYER LCSW-C (EXECUTIVE DIRECTOR)
(301) 251-8965
Entity
Organization
Contact information
Practice address
15701 CRABBS BRANCH WAY, ROCKVILLE, MD 20855-2634
(301) 251-8965
(301) 251-0136
Mailing address
15701 CRABBS BRANCH WAY, ROCKVILLE, MD 20855-2634
(301) 251-8965
(301) 251-0136
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125603300
—
MD
01
—
5458AF
BCBS
MD
01
—
7726
BLUE CROSS BLUE SHIELD
DC
Enumeration date
12/20/2005
Last updated
03/31/2017
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