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 |
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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 |
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