Organization
BREAKTHROUGH THERAPEUTIC CONCEPTS, LLC.
Active
Organization
BREAKTHROUGH THERAPEUTIC CONCEPTS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEONDRA SMITH PSYD (OWNER)
(305) 494-2361
Entity
Organization
Contact information
Practice address
836 RITCHIE HWY STE 12F, SEVERNA PARK, MD 21146-4133
(410) 670-9048
(410) 835-9612
Mailing address
836 RITCHIE HWY STE 12F, SEVERNA PARK, MD 21146-4133
(410) 670-9048
(410) 835-9612
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224276100
—
MD
01
—
DM210001
BCBS PROVIDER ID
—
Enumeration date
04/17/2020
Last updated
07/25/2025
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