Organization
THOMAS CHISLEY BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHELLE THOMAS LCSW-C (CLINICAL SOCIAL WORKER)
(678) 629-8811
Entity
Organization
Contact information
Practice address
3914 NORTHGATE PL, WALDORF, MD 20602-2562
(678) 629-8811
Mailing address
3914 NORTHGATE PL, WALDORF, MD 20602-2562
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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