Healthcare Provider Details

I. General information

NPI: 1609196906
Provider Name (Legal Business Name): NATIONAL INSTITUTE OF RELATIONSHIP ENHANCEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 E WEST HWY SUITE 28
BETHESDA MD
20814-4524
US

IV. Provider business mailing address

4400 E WEST HWY SUITE 28
BETHESDA MD
20814-4524
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-1479
  • Fax: 301-680-3756
Mailing address:
  • Phone: 301-986-1479
  • Fax: 301-680-3756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number08937
License Number StateMD

VIII. Authorized Official

Name: DR. ROBERT FRANC SCUKA
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW-C
Phone: 301-986-1479