Provider Demographics
NPI:1720412570
Name:NEW PROGRESSIONS OF MARYLAND, LLC
Entity Type:Organization
Organization Name:NEW PROGRESSIONS OF MARYLAND, LLC
Other - Org Name:NEW PROGRESSIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOVON
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:336-254-6770
Mailing Address - Street 1:620 GUILFORD COLLEGE RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2292
Mailing Address - Country:US
Mailing Address - Phone:336-254-6770
Mailing Address - Fax:
Practice Address - Street 1:9466 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1456
Practice Address - Country:US
Practice Address - Phone:336-254-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health