| DC Psychotherapy PLLC | |
|
5247 Wisconsin Ave Nw Suite 2 Washington DC 20015-2012 | |
| (202) 271-5673 | |
| Not Available |
| Full Name | DC Psychotherapy PLLC |
|---|---|
| Speciality | Social Worker |
| Location | 5247 Wisconsin Ave Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Cornelia Tietke (SOLE MEMBER) |
| Authorized Official Contact | 2022715673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| DC Psychotherapy PLLC 5247 Wisconsin Ave Nw Suite 2 Washington DC 20015-2012 Ph: (202) 271-5673 | DC Psychotherapy PLLC 5247 Wisconsin Ave Nw Suite 2 Washington DC 20015-2012 Ph: (202) 271-5673 |
| NPI Number | 1285996033 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 06/07/2012 |
| Medicare PECOS PAC ID | 6901109354 |
|---|---|
| Medicare Enrollment ID | O20160120000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285996033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC50079008 (District Of Columbia) | Primary |
| Provider Name | Cornelia Tietke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902196306 PECOS PAC ID: 0446553895 Enrollment ID: I20160120000209 |
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