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Organization

DXT THERAPEUTIC SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE HARE LCPC,LPC,MAC (CLINICAL DIRECTOR)
(240) 676-2895
Entity
Organization

Contact information

Practice address
7610 PENNSYLVANIA AVE STE 301, DISTRICT HEIGHTS, MD 20747-4701
(240) 676-2895
(240) 838-7736
Mailing address
3314 VALLEY FOREST DR, UPPER MARLBORO, MD 20772-9400
(240) 676-2895

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
103TP0016X
Prescribing (Medical) Psychologist
103TP2701X
Group Psychotherapy Psychologist
106H00000X
Marriage & Family Therapist
163WG0000X
General Practice Registered Nurse
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
225XH1200X
Hand Occupational Therapist

Other

Enumeration date
04/10/2019
Last updated
06/11/2019
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