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General NPI Number Information
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NPI Number | 1457749616
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Entity Type | Organization
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Legal Business Name | CATHOLIC FAMILY CLINICIAN NETWORK
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 7007 BRADLEY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-2149
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Country | US
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Telephone | 301-767-1733
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Fax | 301-767-1743
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Provider Business Mailing Address
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Address Line | 7007 BRADLEY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-2149
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Country | US
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Telephone | 301-767-1733
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Fax | 301-767-1743
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. KATHLEEN GALLAGHER
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Credential | LCSW-C
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Telephone | 301-767-1733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LC6097
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License Number State | MD
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