Provider Demographics
NPI:1861906364
Name:THE THERAPY CONNECTION, LLC
Entity type:Organization
Organization Name:THE THERAPY CONNECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP
Authorized Official - Phone:301-358-1128
Mailing Address - Street 1:10610 RHODE ISLAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2500
Mailing Address - Country:US
Mailing Address - Phone:301-358-1128
Mailing Address - Fax:301-476-4199
Practice Address - Street 1:10610 RHODE ISLAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2500
Practice Address - Country:US
Practice Address - Phone:301-358-1128
Practice Address - Fax:301-476-4199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE THERAPY CONNECTION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17295101YM0800X
MDLBA248103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty