=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912116294
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GAIL JANE WINSTON M.S.W.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4601 CONNECTICUT AVE NW SUITE 3
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20008-5700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-686-1177
-----------------------------------------------------
Fax | 202-686-1865
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9614 SUTHERLAND RD
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20901-3262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-589-2233
-----------------------------------------------------
Fax | 202-686-1865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LC300976
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------