Provider Demographics
NPI:1851727226
Name:MARYLAND COUPLES AND FAMILY THERAPY
Entity Type:Organization
Organization Name:MARYLAND COUPLES AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:216-798-7388
Mailing Address - Street 1:14109 BOWSPRIT LN APT 209
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6327
Mailing Address - Country:US
Mailing Address - Phone:216-798-7388
Mailing Address - Fax:
Practice Address - Street 1:14109 BOWSPRIT LN APT 209
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6327
Practice Address - Country:US
Practice Address - Phone:216-798-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty