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NPI Code Detail

MEDICARE: DAVID ANGELICH, PSY. D., PLLC

MEDICARE: DAVID ANGELICH, PSY. D., PLLC
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
1261QM0850XAdult Mental Health Clinic/CenterPSY1000493DC

General Provider Information

NPI Number : 1952670762
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID ANGELICH, PSY. D., PLLC
Provider Business Mailing Address
First Line : 4518 S DAKOTA AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20017-2752
Country : US
Telephone Number : 202-494-6722
Fax Number : 202-248-2466
Provider Business Practice Location Address
First Line : 4115 WISCONSIN AVE NW
Second Line : SUITE 203
City : WASHINGTON
State : DC
Zip : 20016-2812
Country : US
Telephone Number : 202-494-6722
Fax Number : 202-248-2466
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. GEORGE DAVID ANGELICH
Credential : PSY. D.
Telephone Number : 202-494-6722
Provider Enumeration Date : 12/22/2011
Last Update Date : 12/22/2011

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