MEDICARE: POTOMAC BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1255125001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTOMAC BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	2808 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3010
Country	:	US
Telephone Number	:	214-727-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3010
Country	:	US
Telephone Number	:	214-727-4477
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MEGAN CARRACO
Credential	:	LCPC
Telephone Number	:	214-727-4477

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	04/07/2025

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