Healthcare Provider Details

I. General information

NPI: 1154160356
Provider Name (Legal Business Name): NATIONAL CAPITAL TREATMENT AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2503 VIOLET AVE FL 6
BALTIMORE MD
21215-7700
US

IV. Provider business mailing address

200 N GLEBE RD STE 104
ARLINGTON VA
22203-3755
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 571-297-9809
Mailing address:
  • Phone: 703-841-0703
  • Fax: 571-297-9809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AARTI SUBRAMANIAN
Title or Position: CEO
Credential:
Phone: 703-725-4251