Provider Demographics
NPI:1952872558
Name:OLNEY EMDR LLC
Entity Type:Organization
Organization Name:OLNEY EMDR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:301-452-7250
Mailing Address - Street 1:2923 OLNEY SANDY SPRING RD STE A
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1580
Mailing Address - Country:US
Mailing Address - Phone:301-452-7250
Mailing Address - Fax:
Practice Address - Street 1:2923 OLNEY SANDY SPRING RD STE A
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1580
Practice Address - Country:US
Practice Address - Phone:301-452-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-09
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty