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Organization

INNOVATIVE THERAPEUTIC SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISTY CROMARTIE LCPC (CEO)
(301) 455-7872
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
01/22/2010
Last updated
03/09/2012
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