Healthcare Provider Details

I. General information

NPI: 1538572755
Provider Name (Legal Business Name): BETHESDA-CHEVY CHASE ASSESSMENT AND COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 SANGAMORE RD. #S235
BETHESDA MD
20816
US

IV. Provider business mailing address

4701 SANGAMORE RD. #S235
BETHESDA MD
20816
US

V. Phone/Fax

Practice location:
  • Phone: 301-879-0576
  • Fax: 301-384-4703
Mailing address:
  • Phone: 301-681-6789
  • Fax: 301-384-4703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TERESA MARIA GIRAL
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 301-879-0576