| Betty Deberry-sumner, Llc | |
|
10410 Kensington Pkwy Ste 203 Kensington MD 20895-2947 | |
| (240) 506-4040 | |
| (240) 559-0921 |
| Full Name | Betty Deberry-sumner, Llc |
|---|---|
| Speciality | Counselor |
| Location | 10410 Kensington Pkwy Ste 203, Kensington, Maryland |
| Authorized Official Name and Position | Betty J Deberry-sumner (DIRECTOR/OWNER) |
| Authorized Official Contact | 2405064040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Betty Deberry-sumner, Llc 10410 Kensington Pkwy Ste 203 Kensington MD 20895-2947 Ph: (240) 506-4040 | Betty Deberry-sumner, Llc 10410 Kensington Pkwy Ste 203 Kensington MD 20895-2947 Ph: (240) 506-4040 |
| NPI Number | 1114737244 |
|---|---|
| Provider Enumeration Date | 01/10/2025 |
| Last Update Date | 01/10/2025 |
| Certification Date | 01/10/2025 |
| Medicare PECOS PAC ID | 2769902667 |
|---|---|
| Medicare Enrollment ID | O20250221002958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114737244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Betty Jean Deberry-sumner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518518588 PECOS PAC ID: 8022538925 Enrollment ID: I20250221003068 |
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