WILLOW OAK THERAPY CENTER, INC. (NPI# 1386620581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386620581 |
Entity Type | Organization |
Organization Name | WILLOW OAK THERAPY CENTER, INC. |
Other Organization Name | AFFILIATED COMMUNITY COUNSELORS, INC. |
Practice Address |
15701 Crabbs Branch Way Rockville MD 20855-2634 |
Practice Telephone | 3012518965 |
Practice Fax Number | 3012510136 |
Mailing Telephone | 3012518965 |
Mailing Fax Number | 3012510136 |
Enumeration Date | 2005-12-20 |
Last Update Date | 2017-03-31 |
Authorized Official Name | MS. JODY TABNER THAYER (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3012518965 |
Authorized Official Credential | LCSW-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | BCBS | 5458AF | 01 |
DC | BLUE CROSS BLUE SHIELD | 7726 | 01 |
MD | 125603300 | 05 |
Other Name | Type Code |
---|---|
Affiliated Community Counselors, Inc. | Former Legal Business Name - Organization |
Street Address |
15701 CRABBS BRANCH WAY |
City | ROCKVILLE |
State | MD |
Zip Code | 20855-2634 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992343131 | Katharine Ellis | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2019-12-18 |
1598312993 | Hongkyung Julie Youck | Counselor | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2019-08-20 |
1053798470 | Mamata Hotha | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2015-05-05 |
1437571874 | Catherine Tardif-douglin | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2014-01-18 |
1174872964 | Jody Tabner Thayer | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2012-09-07 |
1477847002 | Janet Akman | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2011-05-31 |
1669705109 | Anne-marie Corrado | Social Worker | 15701 Crabbs Branch Way, Rockville, MD 20855-2634 | 2009-09-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801388525 | Michael Robinson | Behavior Technician | 7613 Standish Place, Rockville, MD 20855 | 2018-05-30 |
1144722885 | Samantha Green | Occupational Therapist | 15850 Crabbs Branch Way # 150, Rockville, MD 20855 | 2018-03-07 |
1144690157 | Katrina Williams | Psychologist | 15744 Crabbs Branch Way Ste 100, Derwood, MD 20855 | 2015-10-02 |
1720321888 | Melanie Milczarski Smith | Specialist | 17620-a Redland Road, Rockville, MD 20855 | 2013-03-27 |
1104155167 | Nicole Renee Christenson | Nurse Practitioner | 6001 Muncaster Mill Rd., Rockville, MO 20855 | 2009-12-21 |
1104093244 | Diane Klucinikas Boyd | Audiologist | 18520 Azalea Drive, Derwood, MD 20855 | 2008-05-08 |
1437320413 | Shana Rene Mizzer | Social Worker | 8915 Shady Grove Court, Derwood, MD 20855 | 2008-03-18 |
1083786032 | Mary Foster Herbers | Social Worker | 15521 Villisca Terrace, Rockville, MD 20855 | 2006-11-14 |
1063583698 | Samuel Blum | Dentist | 15720 Crabbs Branch Way, No 1 C, Rockville, MD 20855 | 2006-11-13 |
1538639182 | Jamie Jackson | Behavior Technician | 7529 Standish Pl, Rockville, MD 20855 | 2018-11-27 |
Find all providers in zip 20855 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
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1356816714 | Bluefish Therapy and Consulting, LLC | Clinic/Center | 1680 E Gude Dr, Rockville, MD 20850-1360 | 2018-10-11 |
1942786967 | Nora Talavera Wellness & Health Mental LLC | Clinic/Center | 50 W Edmonston Dr Ste 502, Rockville, MD 20852-1222 | 2018-07-12 |
1861936106 | Oasis Rockville, LLC | Clinic/Center | 3202 Tower Oaks Blvd, Suite 100, Rockville, MD 20852-4219 | 2016-12-06 |
1679997472 | Montgomery County Maryland Government | Clinic/Center | 1301 Piccard Dr, Rockville, MD 20850-4320 | 2014-02-13 |
1780008003 | The Primary Care Coalition of Montgomery County, Maryland | Clinic/Center | 7300 Calhoun Pl Ste 600, Rockville, MD 20855-3701 | 2014-02-06 |
1801227939 | Montgomery County Maryland Government | Clinic/Center | 255 Rockville Pike, Rockville, MD 20850-4153 | 2013-11-27 |
1417227505 | Recovery Health Services, LLC | Clinic/Center | 14701 Avery Rd, Rockville, MD 20853-3605 | 2012-01-05 |
1356649057 | Maryland Treatment Centers, Inc. | Clinic/Center | 14701 Avery Rd, Rockville, MD 20853-3605 | 2011-03-03 |
Find all providers in ROCKVILLE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.