Organization
WISCONSIN AVENUE PSYCHIATRIC CENTER
Active
Other names
Psychiatric Institute of Washington
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES J BAUMGARDNER (VP OF CORP. OPERATIONS)
(202) 885-5679
Entity
Organization
Contact information
Practice address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 966-7374
Mailing address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 966-7374
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074500600
—
MD
Enumeration date
06/20/2013
Last updated
03/28/2014
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