Individual
MADISON WEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, NCSP
Contact information
Practice address
4759 RESERVOIR RD NW, WASHINGTON, DC 20007-1921
(202) 349-8621
Mailing address
4759 RESERVOIR RD NW, WASHINGTON, DC 20007-1921
(202) 349-8621
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY200001670
DC
103TC2200X
Clinical Child & Adolescent Psychologist
PSY200001670
DC
103TP2701X
Group Psychotherapy Psychologist
PSY200001670
DC
103TS0200X
School Psychologist
PSY200001670
DC
Other
Enumeration date
06/09/2021
Last updated
06/09/2025
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