Provider Demographics
NPI:1033002050
Name:DXT THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:DXT THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ALCOHOL AND DRUG SUPERVISO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:LGADC, CAC, CSC, TRA
Authorized Official - Phone:240-676-2895
Mailing Address - Street 1:7610 PENNSYLVANIA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-4764
Mailing Address - Country:US
Mailing Address - Phone:240-838-3707
Mailing Address - Fax:240-470-1223
Practice Address - Street 1:7610 PENNSYLVANIA AVE STE 301
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4764
Practice Address - Country:US
Practice Address - Phone:240-838-3707
Practice Address - Fax:240-470-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty