# WASHINGTON ADVENTIST UNIVERSITY COMMUNITY COUNSELING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518396100
- **Authorized official:** MS. JUDITH ANN UPSHAW LCADC, ABD (CLINICAL SUPERVISOR)
- **Authorized official phone:** (301) 576-0131

## Contact information

- **Practice address:** 7600 FLOWER AVE, SUITE 441-PSYCHOLOGY DEPARTMENT, TAKOMA PARK, MD 20912-7744
- **Practice address phone:** (301) 576-0131
- **Practice address fax:** (301) 891-4054
- **Mailing address:** 7600 FLOWER AVE, SUITE 441-PSYCHOLOGY DEPARTMENT, TAKOMA PARK, MD 20912-7744
- **Mailing address phone:** (301) 576-0131
- **Mailing address fax:** (301) 891-4054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LCA393 | MD | Yes |

## Other

- **Enumeration date:** 11/05/2013
- **Last updated:** 11/05/2013