Healthcare Provider Details

I. General information

NPI: 1740319854
Provider Name (Legal Business Name): HILLCREST CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 RHODE ISLAND AVE NW
WASHINGTON DC
20001-4153
US

IV. Provider business mailing address

915 RHODE ISLAND AVE NW
WASHINGTON DC
20001-4153
US

V. Phone/Fax

Practice location:
  • Phone: 202-232-6100
  • Fax: 202-232-0310
Mailing address:
  • Phone: 202-232-6100
  • Fax: 202-232-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number036525600
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number036525600
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number036525600
License Number StateDC
# 8
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACEY BERNADEAU
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 202-232-6100