Organization
CREATIVE CHANGE THERAPY CENTER LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT ROBERT BEDUHN LCSW-C (PARTNER)
(301) 754-0122
Entity
Organization
Contact information
Practice address
10702 LOMBARDY RD, SILVER SPRING, MD 20901-1631
(301) 754-0122
Mailing address
10702 LOMBARDY RD, SILVER SPRING, MD 20901-1631
(301) 754-0122
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
4026
MD
1041C0700X
Clinical Social Worker
Primary
05659
MD
Other
Enumeration date
05/30/2008
Last updated
09/03/2009
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