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General NPI Number Information
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NPI Number | 1336954684
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Entity Type | Organization
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Legal Business Name | CAPITAL CHILDREN'S WELLNESS CENTER
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 8618 WILD OLIVE DR
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City | POTOMAC
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State | MD
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Zip | 20854-3438
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Country | US
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Telephone | 202-374-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 8618 WILD OLIVE DR
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City | POTOMAC
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State | MD
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Zip | 20854-3438
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Country | US
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Telephone | 202-374-6717
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | DANIELLE MAIZEL
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Credential | MA, LCPC, RPT
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Telephone | 202-374-6717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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