PETRA THERAPEUTIC GROUP LLC (NPI# 1447636386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447636386 |
| Entity Type | Organization |
| Organization Name | PETRA THERAPEUTIC GROUP LLC |
| Other Organization Name | PETRA THERAPEUTIC |
| Practice Address |
9332 Annapolis Rd Ste 304 Lanham MD 20706-3168 |
| Practice Telephone | 3017312823 |
| Practice Fax Number | 3017312833 |
| Mailing Telephone | 3017312823 |
| Mailing Fax Number | 3017312833 |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |
| Authorized Official Name | MR. DARRYL MARSHALL SR. (OWNER) |
| Authorized Official Telephone | 3017312823 |
| Authorized Official Credential | LCSW-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
17942 | MD | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Petra Therapeutic | Doing Business As Name - Organization |
| Street Address |
9332 ANNAPOLIS RD STE 304 |
| City | LANHAM |
| State | MD |
| Zip Code | 20706-3168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992057137 | Darryl Marshall Sr. | Social Worker | 9332 Annapolis Rd Ste 304, Lanham, MD 20706-3170 | 2012-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046775 | Ayesha Tappin | Occupational Therapist | 4200 Parliament Pl. Ste 550, Lanham, MD 20706 | 2019-04-24 |
| 1790240646 | Himabindu Gangavarapu Vinodrao | Nurse Practitioner | 8118, Good Luck Road, Lanhham, MD 20706 | 2019-02-05 |
| 1538644943 | Win Team, LLC | Clinic/Center | 10001 Derekwood Lane, Suite 210, Lanham, MD 20706 | 2018-10-02 |
| 1558846394 | Brieana Moore | Behavioral Analyst | 4551 Parliament Place Suite A, Lanham, MD 20706 | 2018-09-27 |
| 1225511553 | Melvis Afanwi Chi | Home Health Aide | 9861 Goodluck Rd, T1, Lanham, MD 20706 | 2018-09-12 |
| 1346722766 | Elsie Clarke | Nurse Practitioner | 9470 Annapolis Road Suite 311, Lanham, MD 20706 | 2018-09-01 |
| 1821576141 | Amie Da Silva | Nurse Practitioner | 5724 Edge Avenue, Lanham, MD 20706 | 2018-07-30 |
| 1033697313 | Iyadunni Omolara Olukorede | Home Health Aide | 9789 Good Luck Rd Apt 9, Lanham, MD 20706 | 2018-07-30 |
| 1447741459 | A Step Ahead Preventive and Holistic Wellness Center LLC | Psychologist | 4500 Forbes Blvd # 200-w12, Lanham, MD 20706 | 2018-05-24 |
| 1902394398 | Ezekiel Kelechukwu Nwafor | Home Health Aide | 5447 85th Ave Apt 202, Lanham, MD 20706 | 2018-05-01 |
| Find all providers in zip 20706 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588285423 | Safiyya Abdul Bari | Social Worker | 9500 Annapolis Rd Ste A9, Lanham, MD 20706-2060 | 2020-05-01 |
| 1497226914 | Elv Service | Social Worker | 9470 Annapolis Rd Ste 117, Lanham, MD 20706-3031 | 2018-12-10 |
| 1871096982 | Tedrina N Aitkins | Social Worker | 10311 Storch Dr, Lanham, MD 20706-2179 | 2018-03-14 |
| 1851840292 | Edgina Sherman | Social Worker | 10206 Aerospace Rd, Lanham, MD 20706 | 2016-09-27 |
| 1487007043 | Nicole Johnson | Social Worker | 9214 Greenwood Ln, Lanham, MD 20706-3106 | 2016-07-19 |
| 1548624265 | Carnell Windley-ginn | Social Worker | 9332 Annapolis Rd Ste 309, Lanham, MD 20706-3170 | 2016-04-08 |
| 1164811626 | Wendy Kiesha Williams | Social Worker | 4200 Forbes Blvd #104, Lanham, MD 20706-4663 | 2015-01-21 |
| 1326388018 | Shelly Yost | Social Worker | 7800 Good Luck Rd, Lanham, MD 20706-3505 | 2013-02-18 |
| 1326328097 | Dianna Mcfarlane | Social Worker | 9500 Annapolis Rd Ste A8, Lanham, MD 20706-2060 | 2011-08-25 |
| 1215235528 | The Health and Wellness Source, LLC | Social Worker | 4230 Forbes Blvd Ste A, Lanham, MD 20706-4398 | 2011-03-10 |
| Find all providers in LANHAM | ||||
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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.