Provider Demographics
NPI:1740090950
Name:SAFER SPACES THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:SAFER SPACES THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-457-3738
Mailing Address - Street 1:10770 COLUMBIA PIKE STE 300 #1095
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10770 COLUMBIA PIKE STE 300 #1095
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:256-457-3738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty