NPIMap

Organization Active NPI

Thespacebetweenpsychotherapy, LLC

  • Mental Health Counselor
  • Frederick, MD
National Provider Identifier
1215463096
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC6977 Issued in MD
Legal business name
THESPACEBETWEENPSYCHOTHERAPY, LLC
Practice address
605 N Bentz St
Suite 204
Frederick, MD 21701-4982
Phone
(443) 398-1700
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Nina Beth Dillenbeck, MS,NCC, LCPC, CAC-ADNPI 1295174613
Title
Sole MBR
Phone
(443) 398-1700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC6977 MD Primary

Addresses

Primary practice location

605 N Bentz St
Suite 204
Frederick, MD 21701-4982

Mailing address

605 N Bentz St
Suite 204
Frederick, MD 21701-4982
Phone (443) 398-1700

National Provider Directory

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1215463096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N BENTZ ST",
            "address_2": "SUITE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014982",
            "telephone_number": "443-398-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N BENTZ ST",
            "address_2": "SUITE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014982",
            "telephone_number": "443-398-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THESPACEBETWEENPSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "DILLENBECK",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "443-398-1700",
        "authorized_official_credential": "MS,NCC, LCPC, CAC-AD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC6977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.