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General NPI Number Information
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NPI Number | 1659797561
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Entity Type | Organization
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Legal Business Name | NISHA GOPAL, PSYD, PLLC
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Dates
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Enumeration Date | 03/16/2014
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 5100 WISCONSIN AVE NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20016-4130
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Country | US
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Telephone | 202-446-6086
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Fax |
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Provider Business Mailing Address
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Address Line | 5100 WISCONSIN AVE NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20016-4130
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Country | US
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Telephone | 202-446-6086
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. NISHA GOPAL
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Credential | PSY.D.
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Telephone | 202-446-6086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000854
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License Number State | DC
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