NPIMap

Organization Active NPI

Lantern Therapeutic Services, Inc

  • Child & Adolescent Psychiatry Physician
  • Waldorf, MD
National Provider Identifier
1952724205
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
LANTERN THERAPEUTIC SERVICES, INC
Practice address
11680 Doolittle Dr
Suite 111
Waldorf, MD 20602-3801
Phone
(240) 607-2756
Fax
(240) 607-2776
NPI assigned
Jan 22, 2014
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Ms. Karen Jones, LCPC
Title
Clinical Director/ Ceo
Phone
(240) 607-2756

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X
Child & Adolescent Psychiatry Physician 2084P0804X Primary

Addresses

Primary practice location

11680 Doolittle Dr
Suite 111
Waldorf, MD 20602-3801

Mailing address

1282 Smallwood Dr W
Suite 507
Waldorf, MD 20603-4732
Phone (240) 607-2756

Other identifiers 1

IdentifierTypeStateIssuer
420333000MedicaidMD

National Provider Directory

National Provider Directory

Locations

1282 Smallwood Dr W
Waldorf, MD 20603
Phone (301) 266-6861

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1952724205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 SMALLWOOD DR W",
            "address_2": "SUITE 507",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034732",
            "telephone_number": "240-607-2756",
            "fax_number": "240-607-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11680 DOOLITTLE DR",
            "address_2": "SUITE 111",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023801",
            "telephone_number": "240-607-2756",
            "fax_number": "240-607-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANTERN THERAPEUTIC SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/ CEO",
        "authorized_official_telephone_number": "240-607-2756",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420333000",
            "state": "MD"
        }
    ],
    "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 Oct 5, 2023; 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.