Healthcare Provider Details

I. General information

NPI: 1932812047
Provider Name (Legal Business Name): CENTER FOR WOMEN'S PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 11/30/2024
Certification Date: 11/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WILSON BLVD STE 805
ARLINGTON VA
22201-3361
US

IV. Provider business mailing address

2300 WILSON BLVD STE 755
ARLINGTON VA
22201-5424
US

V. Phone/Fax

Practice location:
  • Phone: 646-244-4546
  • Fax:
Mailing address:
  • Phone: 646-244-4546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TRAM HUYNH
Title or Position: MEMBER
Credential: PHD
Phone: 646-244-4546