Healthcare Provider Details

I. General information

NPI: 1376631515
Provider Name (Legal Business Name): CENTER FOR FAMILIES IN TRANSITION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 GEORGIA AVE SUITE 308
SILVER SPRING MD
20910-3638
US

IV. Provider business mailing address

8720 GEORGIA AVE STE 308
SILVER SPRING MD
20910-3614
US

V. Phone/Fax

Practice location:
  • Phone: 301-495-6393
  • Fax: 301-495-6394
Mailing address:
  • Phone: 301-495-6393
  • Fax: 301-495-6394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number04214
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06759
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05623
License Number StateMD

VIII. Authorized Official

Name: MRS. ELLEN SCHAEFER-SALINS
Title or Position: PRESIDENT
Credential: LCSW-C
Phone: 301-495-6393