Provider Demographics
NPI:1497996441
Name:THE CONNECTION THERAPY CENTER
Entity Type:Organization
Organization Name:THE CONNECTION THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MATTHEWS-BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:301-577-4333
Mailing Address - Street 1:4451 PARLIAMENT PLACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-577-4333
Mailing Address - Fax:301-577-5180
Practice Address - Street 1:4451 PARLIAMENT PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-577-4333
Practice Address - Fax:301-577-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty