Provider Demographics
NPI:1134864218
Name:THE THERAPEUTIC LOUNGE, LLC
Entity type:Organization
Organization Name:THE THERAPEUTIC LOUNGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-267-0523
Mailing Address - Street 1:5211 AUTH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4339
Mailing Address - Country:US
Mailing Address - Phone:240-267-0523
Mailing Address - Fax:301-381-8633
Practice Address - Street 1:5211 AUTH RD STE 202
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4339
Practice Address - Country:US
Practice Address - Phone:240-267-0523
Practice Address - Fax:301-381-8633
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE THERAPEUTIC LOUNGE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-03
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty