Healthcare Provider Details

I. General information

NPI: 1134664493
Provider Name (Legal Business Name): NATIONAL CENTER FOR WEIGHT AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 19TH ST NW SUITE 450
WASHINGTON DC
20036-6101
US

IV. Provider business mailing address

1020 19TH ST NW SUITE 450
WASHINGTON DC
20036-6101
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-3077
  • Fax:
Mailing address:
  • Phone: 202-223-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000952
License Number StateDC

VIII. Authorized Official

Name: RACHEL STONE
Title or Position: PRACTICE MANAGER
Credential: MBA
Phone: 202-223-3077