Skip Navigation Link. Please press insert + down arrow if jaws does not start reading the content.

Provider Information for 1518613264


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

RESTORATIVE BEHAVIOR, LLC

Organization Subpart: NO

NPI: 1518613264
Last Updated: 2022-03-04
Certification Date: 2022-03-04

Details

NameValue
NPI1518613264
Enumeration Date2022-02-22
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Ms. EBONIQUE KATRESS MCCLINNAHAN RN, MSN, PMHNP-BC
Title: Owner and Clinician
Phone: 9107971491
Mailing Address 9701 APOLLO DR
UPPER MARLBORO, MD 20774-4783
United States

Phone: 301-798-6125 | Fax:301-355-0276
 
Primary Practice Address 9701 APOLLO DR
UPPER MARLBORO, MD 20774-4783
United States

Phone: 301-798-6125 | Fax:301-355-0276
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
CONNECT URL
www.restorativebehavior.com
Secured electronic health platform
Direct CSV 9701 Apollo Dr
Upper Marlboro, MD 20774-4783
United States
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)MD6660066.Aetna
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 193400000X - Single Specialty Group
363LP0808X - Nurse Practitioner - Psych/Mental Health
Yes 261QM0850X - Clinic/Center - Adult Mental Health