Healthcare Provider Details
I. General information
NPI: 1629131768
Provider Name (Legal Business Name): GRACE CHAPIN METZ LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 CONNECTICUT AVE NW SUITE 300
WASHINGTON DC
20008-1158
US
IV. Provider business mailing address
4201 CONNECTICUT AVE NW SUITE 300
WASHINGTON DC
20008-1158
US
V. Phone/Fax
- Phone: 202-624-0010
- Fax: 202-624-0062
- Phone: 202-624-0010
- Fax: 202-624-0062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LC303559 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: