Individual
DR. PETER JOSEPH ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1350 CONNECTICUT AVE NW STE 500, WASHINGTON, DC 20036-1736
(202) 790-9725
(202) 342-2415
Mailing address
3810 GARFIELD ST NW, WASHINGTON, DC 20007-1368
(202) 352-2203
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05429
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BU71-0001
CAREFIRST BLUECROSS BLUESHIELD
MD
Enumeration date
03/15/2012
Last updated
09/11/2025
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