Etw Therapeutic & Holistic Services LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

ETW THERAPEUTIC & HOLISTIC SERVICES LLC

Practice address

7305 Baltimore Ave # A101
College Park, MD 20740-3234

Phone

(202) 743-5660

NPI assigned

Sep 15, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Priyanka Malhotra

Title

Credentialing Director

Phone

(301) 377-1836

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Etw Therapeutic Holistic Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Etw Therapeutic & Holistic Services LLC

  • Adult Mental Health Clinic/Center
  • College Park, MD
  • NPI 1083336580
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Whitaker, PHD, LCSW-C, LICSW

  • Clinical Social Worker
  • Fort Washington, MD
  • NPI 1225436231
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1053033126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 SHOCKLEY CT",
            "city": "FT WASHINGTON",
            "state": "MD",
            "postal_code": "207441711",
            "telephone_number": "202-743-5660",
            "fax_number": "410-824-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 BALTIMORE AVE # A101",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207403234",
            "telephone_number": "202-743-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETW THERAPEUTIC & HOLISTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "PRIYANKA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "301-377-1836"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555991000",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "etwtherapy.com",
            "affiliation": "N",
            "endpointDescription": "etwtherapy.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "na",
            "address_1": "10903 Indian Head Hwy Ste 404",
            "city": "Ft Washington",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207444019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elaine Ellis Center of Health, Inc.
• Scott A Ellis, MS, ATC
• Helina Airoboma Esene, NP
• Cecile Eleh Edie Etoke
• Olatunde Etti-Williams
• Etw Therapeutic & Holistic Services LLC
• Etw Therapeutic & Holistic Services LLC
• Lisa Marie Euliss, RD, LDN
• Evolve Therapy & Wellness LLC
• Expert Smiles, Inc

• Rehabilitation Clinic/Center in College Park, MD
• Providers in College Park, MD by specialty
• Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.