MEDICARE: METROPOLITAN THERAPEUTIC SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PRC1370	DC
2	101YP2500X	Professional Counselor	PRC173	DC
3	103TC0700X	Clinical Psychologist	04859	MD
4	2084P0800X	Psychiatry Physician	MD22004	DC
5	363L00000X	Nurse Practitioner	CN1000286	DC
6	101YP2500X	Professional Counselor	PRC13770	DC

General Provider Information

NPI Number	:	1427303197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPOLITAN THERAPEUTIC SERVICES, INC.

Provider Business Mailing Address
First Line	:	1425 K ST NW
Second Line	:	SUITE #350
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3500
Country	:	US
Telephone Number	:	202-302-0448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 K ST NW
Second Line	:	SUITE #350
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3500
Country	:	US
Telephone Number	:	202-302-0448
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MILDRED NAMLE NTI
Credential	:	PHD
Telephone Number	:	202-302-0448

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	07/19/2012

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