Healthcare Provider Details

I. General information

NPI: 1043840085
Provider Name (Legal Business Name): DC ANXIETY AND OCD CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2168 WISCONSIN AVE NW
WASHINGTON DC
20007-2280
US

IV. Provider business mailing address

2168 WISCONSIN AVE NW
WASHINGTON DC
20007-2280
US

V. Phone/Fax

Practice location:
  • Phone: 202-867-6918
  • Fax:
Mailing address:
  • Phone: 202-867-6918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MIA PAUSTIAN
Title or Position: CLINICAL PSYCHOLOGIST, FOUNDER
Credential: PHD
Phone: 202-867-6918