Provider Demographics
NPI:1679315634
Name:EMOTIONAL AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:EMOTIONAL AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST, LCSW-C
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHANSIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:301-825-9392
Mailing Address - Street 1:325 ELLINGTON BLVD STE 361
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4591
Mailing Address - Country:US
Mailing Address - Phone:301-825-9392
Mailing Address - Fax:301-825-9392
Practice Address - Street 1:18310 MONTGOMERY VILLAGE AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879
Practice Address - Country:US
Practice Address - Phone:301-825-9392
Practice Address - Fax:301-825-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty