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General NPI Number Information
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NPI Number | 1568692002
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Entity Type | Individual
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Provider Name | ELIA HEIDIANN CHARLES MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 9080 BEALE RD BLDG 623
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City | BETHESDA
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State | MD
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Zip | 20889-5633
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Country | US
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Telephone | 301-400-2284
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Fax |
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Provider Business Mailing Address
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Address Line | 701 BRANDYWINE ST SE UNIT 101
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City | WASHINGTON
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State | DC
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Zip | 20032-3551
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Country | US
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Telephone | 202-629-3026
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50078580
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License Number State | DC
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