Healthcare Provider Details

I. General information

NPI: 1699012930
Provider Name (Legal Business Name): COLUMBIA ASSOCIATES IN PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N GLEBE RD SUITE 303
ARLINGTON VA
22207-3558
US

IV. Provider business mailing address

2501 N GLEBE RD SUITE 303
ARLINGTON VA
22207-3558
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-1290
  • Fax: 703-841-1315
Mailing address:
  • Phone: 703-841-1290
  • Fax: 703-841-1315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: GARY SPIVACK
Title or Position: OWNER
Credential: M.D.
Phone: 703-841-1290