NPIMap

Organization Active NPI

Integrative Therapeutic Solutions, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waldorf, MD
National Provider Identifier
1073356119
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
INTEGRATIVE THERAPEUTIC SOLUTIONS, LLC
Practice address
3200 Crain Hwy Ste 205
Waldorf, MD 20603-4843
Phone
(240) 448-2475
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Dr. Robert L Evans III, PHD, LCPC, CCTP-II,
Title
Ceo
Phone
(202) 441-7989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

3200 Crain Hwy Ste 205
Waldorf, MD 20603-4843

Mailing address

3200 Crain Hwy Ste 205
Waldorf, MD 20603-4843
Phone (240) 448-2475

National Provider Directory

National Provider Directory
Tax ID family
Integrative Therapeutic Solutions LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1073356119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY STE 205",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034843",
            "telephone_number": "240-448-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY STE 205",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034843",
            "telephone_number": "240-448-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE THERAPEUTIC SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-441-7989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHD, LCPC, CCTP-II,"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.