| Wisconsin Ave Psychiatric Center Inc | |
|
4228 Wisconsin Ave Nw Washington DC 20016-2138 | |
| (202) 885-5600 | |
| (202) 885-5842 |
| Full Name | Wisconsin Ave Psychiatric Center Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4228 Wisconsin Ave Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Charles J Baumgardner (CEO) |
| Authorized Official Contact | 2028855600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Ave Psychiatric Center Inc 4228 Wisconsin Ave Nw Washington DC 20016-2138 Ph: (202) 885-5600 | Wisconsin Ave Psychiatric Center Inc 4228 Wisconsin Ave Nw Washington DC 20016-2138 Ph: (202) 885-5600 |
| NPI Number | 1801279393 |
|---|---|
| Provider Enumeration Date | 07/02/2015 |
| Last Update Date | 07/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801279393 | NPI | - | NPPES |
| 448740100 | Medicaid | MD | |
| 569223 | Other | MEDICARE | |
| 026392500 | Medicaid | DC | |
| 074500600 | Medicaid | MD | |
| 208290000 | Medicaid | MD | |
| 026402100 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | HFD01-0011 (District Of Columbia) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Primary |
Joan R Sealy Mdpc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6941 32nd St Nw, Washington, DC 20015 Phone: 202-244-6946 | |
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