Thomas Chisley Behavioral Health Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THOMAS CHISLEY BEHAVIORAL HEALTH SERVICES, LLC

Practice address

3914 Northgate PL
Waldorf, MD 20602-2562

Phone

(678) 629-8811

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Rachelle Thomas, LCSW-CNPI 1659037174

Title

Clinical Social Worker

Phone

(678) 629-8811

Specialties & licenses 5

Addresses

Practitioners 1

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

• Rachelle Thomas, LCSW-C

  • Clinical Social Worker
  • Waldorf, MD
  • NPI 1659037174
  NPD Authorized official

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1316690340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 NORTHGATE PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 NORTHGATE PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022562",
            "telephone_number": "678-629-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS CHISLEY BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "678-629-8811",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Therapeutic Behavioral Dynamics LLC
• Thomas M. Kline D.C.,P.a.
• Thomas M. Kline, D.C.,P.a.
• Jurnee Thomas
• Kennedy Marie Thomas
• Kenneth C Thomas, LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.