Waverly Center for Psychotherapy, LLC

Primary specialty

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

Legal business name

WAVERLY CENTER FOR PSYCHOTHERAPY, LLC

Practice address

13708 Captain Marbury LN
Upper Marlboro, MD 20772-6118

Phone

(301) 417-5506

Fax

(301) 235-1587

NPI assigned

Dec 27, 2020

Last updated

Dec 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly R Woodard, LCPCNPI 1629425186

Title

Principal Member

Phone

(301) 417-5506

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly R Woodard, LGPC

  • Professional Counselor
  • Upper Marlboro, MD
  • NPI 1629425186
  NPD Authorized official

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609027200000",
    "number": "1700473659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13708 CAPTAIN MARBURY LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207726118",
            "telephone_number": "301-417-5506",
            "fax_number": "301-235-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13708 CAPTAIN MARBURY LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207726118",
            "telephone_number": "301-417-5506",
            "fax_number": "301-235-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY CENTER FOR PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-27",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRINCIPAL MEMBER",
        "authorized_official_telephone_number": "301-417-5506",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shani Watson, LCPC
• Soroya Watson, RN, IBCLC
• Watts Dental Associates
• Sonja Watts-Means, MSW
• Richard Watts, D.D.S.
• Wayman Brown, D.D.S. , P.C.
• Akira Wayman
• Ways to Thrive Therapy
• We Care Adult Services Inc.
• We Care Adult Services, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Upper Marlboro, MD
• Providers in Upper Marlboro, 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 Dec 27, 2020; 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.