NPIMap

Organization Active NPI

Body Image Therapy Center Intensive

  • Multi-Specialty Clinic/Center
  • Washington, DC
National Provider Identifier
1982035994
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BODY IMAGE THERAPY CENTER INTENSIVE
Practice address
2639 Connecticut Ave NW Ste 251
Washington, DC 20008-2651
Phone
(877) 674-2843
NPI assigned
Dec 2, 2013
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
THE BODY IMAGE THERAPY CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Jeremy Reals
Title
Outpatient Operations Manager
Phone
(202) 819-5000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Mental Health Counselor 101YM0800X MD
Clinical Social Worker 1041C0700X MD
Nutritionist 133N00000X MD
Registered Dietitian 133V00000X

Addresses

Primary practice location

2639 Connecticut Ave NW Ste 251
Washington, DC 20008-2651

Mailing address

2639 Connecticut Ave NW Ste 251
Washington, DC 20008-2651
Phone (240) 722-1014

Other practice location 1

9192 Red Branch Rd
Suite 270
Columbia, MD 21045-2030
Phone (443) 602-6515

Other practice location 2

3521 Buckeystown Pike
Buckeystown, MD 21717
Phone (877) 674-2843

National Provider Directory

National Provider Directory
Part of
The Body Image Therapy Center LLC

Locations

2639 Connecticut Ave NW
Ste 251
Washington, DC 20008
Phone (240) 722-1014

1734 Maryland Ave
Ste 200
Baltimore, MD 21201
Phone (240) 722-1014

9192 Red Branch Rd
Ste 270
Columbia, MD 21045
Phone (410) 299-2272

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1982035994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 CONNECTICUT AVE NW STE 251",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082651",
            "telephone_number": "240-722-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 CONNECTICUT AVE NW STE 251",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082651",
            "telephone_number": "877-674-2843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9192 Red Branch Rd",
            "address_2": "Suite 270",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452030",
            "country_code": "US",
            "telephone_number": "443-602-6515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3521 Buckeystown Pike",
            "address_purpose": "LOCATION",
            "city": "Buckeystown",
            "state": "MD",
            "postal_code": "21717",
            "country_code": "US",
            "telephone_number": "877-674-2843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BODY IMAGE THERAPY CENTER INTENSIVE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE BODY IMAGE THERAPY CENTER, LLC",
        "enumeration_date": "2013-12-02",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "REALS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OUTPATIENT OPERATIONS MANAGER",
        "authorized_official_telephone_number": "202-819-5000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.