Provider Demographics
NPI:1770118119
Name:NEUROPLACID PSYCHOTHERAPY INC.
Entity type:Organization
Organization Name:NEUROPLACID PSYCHOTHERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVADI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MS, LCPC
Authorized Official - Phone:301-717-9989
Mailing Address - Street 1:11108 BROAD GREEN DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2021
Mailing Address - Country:US
Mailing Address - Phone:301-299-2921
Mailing Address - Fax:
Practice Address - Street 1:11108 BROAD GREEN DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2021
Practice Address - Country:US
Practice Address - Phone:301-299-2921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD095112900Medicaid