Organization
CTB BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIUS CASSELLAS (CFO)
(704) 840-9726
Entity
Organization
Contact information
Practice address
8787 BRANCH AVE, CLINTON, MD 20735-2630
(301) 795-2151
(301) 795-2152
Mailing address
5934 BRIGHTSTAR VALLEY RD, MINT HILL, NC 28227-7691
(704) 840-9726
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/01/2013
Last updated
02/01/2013
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