Healthcare Provider Details

I. General information

NPI: 1578998563
Provider Name (Legal Business Name): THE ROSS CENTER FOR ANXIETY & RELATED DISORDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW SUITE 400
WASHINGTON DC
20015-2014
US

IV. Provider business mailing address

5225 WISCONSIN AVE NW SUITE 400
WASHINGTON DC
20015-2014
US

V. Phone/Fax

Practice location:
  • Phone: 202-363-1010
  • Fax: 202-363-2383
Mailing address:
  • Phone: 202-363-1010
  • Fax: 202-363-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number261135371
License Number StateDC

VIII. Authorized Official

Name: MRS. MARY ELIZABETH SALCEDO
Title or Position: OWNER
Credential: M.D.
Phone: 202-363-1010