Healthcare Provider Details

I. General information

NPI: 1184930695
Provider Name (Legal Business Name): TRISHA SEWPAUL LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 MONTROSE RD SUITE 200
ROCKVILLE MD
20852-4817
US

IV. Provider business mailing address

5028 WISCONSIN AVE NW SUITE 400
WASHINGTON DC
20016-4118
US

V. Phone/Fax

Practice location:
  • Phone: 202-360-4787
  • Fax:
Mailing address:
  • Phone: 202-360-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13212
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: