Provider Demographics
NPI:1871356857
Name:TALK THERAPY POTOMAC LLC
Entity type:Organization
Organization Name:TALK THERAPY POTOMAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:224-628-3108
Mailing Address - Street 1:1201 SEVEN LOCKS RD STE 360
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6901
Mailing Address - Country:US
Mailing Address - Phone:224-628-3108
Mailing Address - Fax:
Practice Address - Street 1:8800 HARNESS TRL
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2555
Practice Address - Country:US
Practice Address - Phone:224-628-3108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty