Healthcare Provider Details

I. General information

NPI: 1275513251
Provider Name (Legal Business Name): CIRCLE TREATMENT CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 SHIRLEY LN
CHEVY CHASE MD
20815-3906
US

IV. Provider business mailing address

3309 SHIRLEY LN
CHEVY CHASE MD
20815-3906
US

V. Phone/Fax

Practice location:
  • Phone: 301-258-2626
  • Fax: 301-654-1612
Mailing address:
  • Phone: 301-258-2626
  • Fax: 301-654-1612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMD2123
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810002291
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number4106
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSALIND GOLDFARB
Title or Position: OWNER DIRECTOR
Credential: PH LCDC
Phone: 301-258-2626