Provider Demographics
NPI:1922717644
Name:REFLECTIVE THERAPEUTIC AND HOLISTIC SERVICES LLC
Entity Type:Organization
Organization Name:REFLECTIVE THERAPEUTIC AND HOLISTIC SERVICES LLC
Other - Org Name:REFLECTIVE THERAPEUTIC AND HOLISTIC LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-274-9269
Mailing Address - Street 1:1220 E JOPPA RD STE 400H
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5811
Mailing Address - Country:US
Mailing Address - Phone:443-243-3193
Mailing Address - Fax:
Practice Address - Street 1:1220 E JOPPA RD STE 400H
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5811
Practice Address - Country:US
Practice Address - Phone:443-243-3193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)