| Theodora Adedeji, | |
| 
					1 Research Ct, Rockville, MD 20850-3221  | |
| (301) 259-5359 | |
| (301) 246-6523 | 
| Full Name | Theodora Adedeji | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 1 Research Ct, Rockville, Maryland | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1437717246 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PRC13603 (District Of Columbia) | Secondary | 
| 101YP2500X | Counselor - Professional | LC3148 (Maryland) | Primary | 
| Entity Name | Integrated Wellness Haven Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1538935812 PECOS PAC ID: 5294170254 Enrollment ID: O20240229001102  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Theodora Adedeji, 1 Research Ct Ste 450, Rockville, MD 20850-6252 Ph: (301) 259-5359  | Theodora Adedeji, 1 Research Ct, Rockville, MD 20850-3221 Ph: (301) 259-5359  | 
Mr. Jeff Shinal, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 966 Hungerford Dr, Suite 14a, Rockville, MD 20850 Phone: 703-585-1066 Fax: 703-771-4022  | |
Ersilia Bostian, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 W Montgomery Ave, Suite 320, Rockville, MD 20850 Phone: 301-678-3385  | |
Ms. Elana Woolf, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 966 Hungerford Dr # 7a, Rockville, MD 20850 Phone: 202-686-5834  | |
Mrs. Patricia Gillen Doane, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 9807 Veirs Dr Apt 301, Rockville, MD 20850 Phone: 240-464-8294 Fax: 301-983-1953  | |
Denine Rachelle Bowman, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 20 Courthouse Sq, Suite 202, Rockville, MD 20850 Phone: 301-424-6955  | |
Ms. Stacey Ann Rowcliffe, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 100 1st St Apt 425, Rockville, MD 20851 Phone: 406-671-4270  | |
Mr. Freydun Fred Goudarznia, MA LCPC Counselor Medicare: Medicare Enrolled Practice Location: 932 Hungerford Dr, Rockville, MD 20850 Phone: 240-393-6720  |