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Contact Information

THE INDIGO CHILD THERAPEUTIC LLC
7491 OLD ALEXANDRIA FERRY RD
CLINTON, MD20772
 Phone: 202-277-5378
 Fax: 240-269-7799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Behavior Analyst

103K00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Occupational Therapy Assistant

224Z00000X
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Speech-Language Assistant

2355S0801X
Indicates primary specialty

NPI Profile & details for THE INDIGO CHILD THERAPEUTIC LLC

NPI Number 1912514910
LBN Legal business name THE INDIGO CHILD THERAPEUTIC LLC
Authorized official TIFFANY DICKS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/24/2020
Last updated 10/23/2024 - More than a year ago
Identifiers
MD Medicaid 444331400
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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