Healthcare Provider Details

I. General information

NPI: 1801904685
Provider Name (Legal Business Name): WASHINGTON PSYCHOLOGICAL CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW SUITE 513
WASHINGTON DC
20015-2014
US

IV. Provider business mailing address

5225 WISCONSIN AVE NW SUITE 513
WASHINGTON DC
20015-2014
US

V. Phone/Fax

Practice location:
  • Phone: 202-364-1575
  • Fax: 202-364-0561
Mailing address:
  • Phone: 202-364-1575
  • Fax: 202-364-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number301628
License Number StateDC

VIII. Authorized Official

Name: BARRY W. MCCARTHY
Title or Position: PRESIDENT
Credential: PHD
Phone: 202-364-1575