NPIMap

Organization Active NPI

Shake the Dust Therapy, LLC

  • Adult Mental Health Clinic/Center
  • Germantown, MD
National Provider Identifier
1063119014
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SHAKE THE DUST THERAPY, LLC
Practice address
11509 Sir Spencer Way
Germantown, MD 20876-6003
Phone
(301) 717-8124
NPI assigned
Feb 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Michele Arora, LCSW-CNPI 1649827148
Title
Resident Agent
Phone
(301) 717-8124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

11509 Sir Spencer Way
Germantown, MD 20876-6003

Mailing address

267 Kentlands Blvd
Gaithersburg, MD 20878-5446
Phone (301) 717-8124

National Provider Directory

National Provider Directory
Tax ID family
Shake the Dust Therapy 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1063119014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446",
            "telephone_number": "301-717-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11509 SIR SPENCER WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766003",
            "telephone_number": "301-717-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKE THE DUST THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "RESIDENT AGENT",
        "authorized_official_telephone_number": "301-717-8124",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.