Organization
WASHINGTON ADVENTIST UNIVERSITY COMMUNITY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH ANN UPSHAW LCADC, ABD (CLINICAL SUPERVISOR)
(301) 576-0131
Entity
Organization
Contact information
Practice address
7600 FLOWER AVE, SUITE 441-PSYCHOLOGY DEPARTMENT, TAKOMA PARK, MD 20912-7744
(301) 576-0131
(301) 891-4054
Mailing address
7600 FLOWER AVE, SUITE 441-PSYCHOLOGY DEPARTMENT, TAKOMA PARK, MD 20912-7744
(301) 576-0131
(301) 891-4054
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA393
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SAMIS100033
OHCQ
—
Enumeration date
11/05/2013
Last updated
11/05/2013
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