Provider Demographics
NPI:1386840452
Name:NEW DIMENSION THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:NEW DIMENSION THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-322-9190
Mailing Address - Street 1:PO BOX 6773
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-6773
Mailing Address - Country:US
Mailing Address - Phone:301-322-9190
Mailing Address - Fax:301-322-1704
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:SUITE 331
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4783
Practice Address - Country:US
Practice Address - Phone:301-322-9190
Practice Address - Fax:301-322-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD086671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD08667OtherLCSW-C LICENSE