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Organization
GREEN DOOR BEHAVIORAL HEALTH
Active
Organization
GREEN DOOR BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD BEBOUT PH.D. (CEO)
(202) 464-9200
Entity
Organization
Contact information
Practice address
1221 TAYLOR ST NW, WASHINGTON, DC 20011-5617
(202) 464-9200
(202) 464-5740
Mailing address
1221 TAYLOR ST NW, WASHINGTON, DC 20011-5617
(202) 464-9200
(202) 464-5740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
54000690
DC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
DC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036561200
—
DC
05
—
057062300
—
DC
Enumeration date
03/05/2007
Last updated
05/05/2016
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