Healthcare Provider Details

I. General information

NPI: 1306760889
Provider Name (Legal Business Name): PATRICK J GAITAN LGSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 CONNECTICUT AVE NW
WASHINGTON DC
20036-1111
US

IV. Provider business mailing address

24 JEFFERSON AVE
TAKOMA PARK MD
20912-5736
US

V. Phone/Fax

Practice location:
  • Phone: 202-779-5769
  • Fax:
Mailing address:
  • Phone: 240-246-4778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200006924
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: