Provider Demographics
NPI:1053843029
Name:THERAPEUTIC SUPERVENTIONS, INC.
Entity Type:Organization
Organization Name:THERAPEUTIC SUPERVENTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARPHARE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-256-5243
Mailing Address - Street 1:14373 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MD
Mailing Address - Zip Code:21036-1014
Mailing Address - Country:US
Mailing Address - Phone:301-256-5243
Mailing Address - Fax:443-583-3872
Practice Address - Street 1:3905 NATIONAL DR STE 230
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6101
Practice Address - Country:US
Practice Address - Phone:240-650-0779
Practice Address - Fax:443-583-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 103T00000X, 103TB0200X
MD03945103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty