Provider Demographics
NPI:1255848800
Name:NYLU THERAPEUTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:NYLU THERAPEUTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLEASANTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, NCC
Authorized Official - Phone:301-684-4606
Mailing Address - Street 1:15020 NEWCOMB LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1027
Mailing Address - Country:US
Mailing Address - Phone:301-684-4606
Mailing Address - Fax:240-331-0545
Practice Address - Street 1:4329 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2601
Practice Address - Country:US
Practice Address - Phone:301-684-4606
Practice Address - Fax:240-331-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1039814P0000Medicaid
MD008012800Medicaid