MEDICARE: CIRCLE TREATMENT CENTER PC

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	103T00000X	Psychologist	MD2123	MD
2	103TC0700X	Clinical Psychologist	0810002291	VA
3	103TA0400X	Addiction (Substance Use Disorder) Psychologist	4106	MD
4	103TC0700X	Clinical Psychologist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	283821	OTHER	MD	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275513251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLE TREATMENT CENTER PC

Provider Business Mailing Address
First Line	:	3309 SHIRLEY LN
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3906
Country	:	US
Telephone Number	:	301-258-2626
Fax Number	:	301-654-1612

Provider Business Practice Location Address
First Line	:	3309 SHIRLEY LN
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3906
Country	:	US
Telephone Number	:	301-258-2626
Fax Number	:	301-654-1612

Authorized Official
Title or Position	:	OWNER DIRECTOR
Name	:	DR. ROSALIND GOLDFARB
Credential	:	PH LCDC
Telephone Number	:	301-258-2626

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/21/2021

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Directions to “CIRCLE TREATMENT CENTER PC ” Practice Location

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