| Organization Name: | PSYCHOTHERAPEUTIC SERVICES OF SOUTHERN MARYLAND |
| NPI Number: | 1477613578 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDALL COOPER (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 337 Brightseat Rd Sutie 106 And 107 Landover |
| State: | MD US |
| Postal Code: | 207854736 |
| Phone Number: | 3014991474 |
| Fax Number: | 3014990145 |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TP2701X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Group Psychotherapy |
| Taxonomy Definition: | |