Active NPI
Integrative Therapeutic Solutions, LLC
- Rehabilitation Clinic/Center
- Waldorf, MD
National Provider Identifier
1437880556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Clinic/Center
- Legal business name
- INTEGRATIVE THERAPEUTIC SOLUTIONS, LLC
- Practice address
- 3200 Crain Hwy Ste 205
Waldorf, MD 20603-4843 - Phone
- (240) 448-2475
- Fax
- (240) 448-2335
- NPI assigned
- Jun 20, 2022
- Organization subpart
- No
NPPES NPI Registry
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
- Co-Owner
- Phone
- (202) 441-7989
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891005700 | Medicaid | MD |
National Provider Directory
National Provider Directory- Tax ID family
- Integrative Therapeutic Solutions LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Waldorf, MD
- NPI 1073356119
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Waldorf, MD
- NPI 1386414662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1704585600000",
"number": "1437880556",
"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",
"fax_number": "240-448-2335"
},
{
"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",
"fax_number": "240-448-2335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRATIVE THERAPEUTIC SOLUTIONS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-20",
"last_updated": "2024-01-07",
"certification_date": "2024-01-07",
"status": "A",
"authorized_official_last_name": "EVANS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CO-OWNER",
"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": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891005700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
- Institute for Behavioral Change, Inc.
- Institute for Behavioral Change, Inc.
- Institute for Behavioral Change, Inc.
- Integrative Therapeutic Solutions, LLC
- Integrative Therapeutic Solutions, LLC
- Vincent Ippolito, R.P.H.
- Samuel B Itscoitz, MD
- Ingrid Ives-Pinkney, NCC, LCPC
- Grace Dhikusooka Ivumbi
- Najmeh Izadpanah, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.