Organization
BODY IMAGE THERAPY CENTER INTENSIVE
Active
Parent organization
THE BODY IMAGE THERAPY CENTER, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE BODY IMAGE THERAPY CENTER, LLC
Authorized official
JEREMY REALS (OUTPATIENT OPERATIONS MANAGER)
(202) 819-5000
Entity
Organization
Contact information
Practice address
2639 CONNECTICUT AVE NW STE 251, WASHINGTON, DC 20008-2651
(877) 674-2843
Mailing address
2639 CONNECTICUT AVE NW STE 251, WASHINGTON, DC 20008-2651
(240) 722-1014
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MD
1041C0700X
Clinical Social Worker
—
MD
133N00000X
Nutritionist
—
MD
133V00000X
Registered Dietitian
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2013
Last updated
03/23/2022
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