Healthcare Provider Details

I. General information

NPI: 1811794092
Provider Name (Legal Business Name): SAEED HASSON PATE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-2167
US

IV. Provider business mailing address

1614 WHEYFIELD DR
FREDERICK MD
21701-9335
US

V. Phone/Fax

Practice location:
  • Phone: 404-552-3933
  • Fax:
Mailing address:
  • Phone: 404-552-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number987456A
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5894
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number1234
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: