Provider Demographics
NPI:1730885104
Name:OCD DC LLC
Entity type:Organization
Organization Name:OCD DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BRECKENRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCSW, LICSW
Authorized Official - Phone:240-618-3581
Mailing Address - Street 1:1104 CARNATION DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2043
Mailing Address - Country:US
Mailing Address - Phone:240-401-3853
Mailing Address - Fax:
Practice Address - Street 1:1104 CARNATION DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2043
Practice Address - Country:US
Practice Address - Phone:240-401-3853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health