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General NPI Number Information
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NPI Number | 1538705231
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Entity Type | Individual
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Provider Name | GRETA CARLSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 2 WISCONSIN CIR STE 915
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City | CHEVY CHASE
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State | MD
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Zip | 20815-7036
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Country | US
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Telephone | 301-938-8431
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Fax |
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Provider Business Mailing Address
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Address Line | 4450 S PARK AVE APT 502
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City | CHEVY CHASE
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State | MD
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Zip | 20815-3635
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Country | US
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Telephone | 301-938-8431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810007878
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 06762
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY200001358
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License Number State | DC
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