Provider Demographics
NPI:1992815385
Name:C & L THERAPIES, INC
Entity type:Organization
Organization Name:C & L THERAPIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPADA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:443-668-6942
Mailing Address - Street 1:8415 BELLONA LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2055
Mailing Address - Country:US
Mailing Address - Phone:443-668-6942
Mailing Address - Fax:410-285-0560
Practice Address - Street 1:8415 BELLONA LN
Practice Address - Street 2:SUITE 107
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2055
Practice Address - Country:US
Practice Address - Phone:443-668-6942
Practice Address - Fax:410-285-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04110103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD356PMedicare PIN