OrganizationActive
Institute for Behavioral Change, Inc.
NPI 1124298484 · Clinical Child & Adolescent Psychologist · Waldorf, MD
Provider details
- NPI number
- 1124298484
- Entity type
- Organization
- Primary specialty
- Clinical Child & Adolescent PsychologistBehavioral Health & Social Service Providers
- Authorized official
- Howard Mabry, Ceo
- License
- 103000A-DT-Y-068 (DC)
Practice location
2670 Crain Hwy Ste 205
Waldorf, MD 20601-2816
Phone: (301) 818-0092
Fax: (301) 818-0110
Mailing address
2670 Crain Hwy Ste 205
Waldorf, MD 20601-2816
Registry dates
- Enumerated
- 2008-03-03
- Last updated
- 2023-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.