=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104634864
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SINGULAR PSYCHOTHERAPY CENTER OF DC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2024
-----------------------------------------------------
Last Update Date | 12/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5028 WISCONSIN AVE NW STE 260
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20016-4118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-766-3518
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5028 WISCONSIN AVE NW STE 260
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20016-4118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-766-3518
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. LUIS GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 202-766-3518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TP2701X
-----------------------------------------------------
Taxonomy Name | Group Psychotherapy Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------