| Innovative Therapeutic Services, Llc | |
|
14440 Cherry Lane Ct Suite 208 Laurel MD 20707-4946 | |
| (301) 604-1458 | |
| Not Available |
| Full Name | Innovative Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 14440 Cherry Lane Ct, Laurel, Maryland |
| Authorized Official Name and Position | Misty Cromartie (CEO) |
| Authorized Official Contact | 3014557872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Therapeutic Services, Llc 14440 Cherry Lane Ct Suite 208 Laurel MD 20707-4946 Ph: (301) 604-1458 | Innovative Therapeutic Services, Llc 14440 Cherry Lane Ct Suite 208 Laurel MD 20707-4946 Ph: (301) 604-1458 |
| NPI Number | 1003147505 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 03/09/2012 |
| Medicare PECOS PAC ID | 9436388345 |
|---|---|
| Medicare Enrollment ID | O20140218000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003147505 | NPI | - | NPPES |
| Provider Name | Marcia J Hancock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073884995 PECOS PAC ID: 8022247931 Enrollment ID: I20140224001962 |
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