Organization
WISCONSIN AVE PSYCHIATRIC CENTER INC
Active
Other names
Psychiatric Institute of Washington
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES J BAUMGARDNER (CEO)
(202) 885-5600
Entity
Organization
Contact information
Practice address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 885-5842
Mailing address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 885-5842
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
HFD01-0011
DC
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026392500
—
DC
05
—
026402100
—
DC
05
—
074500600
—
MD
05
—
208290000
—
MD
05
—
448740100
—
MD
01
—
569223
MEDICARE
—
Enumeration date
07/02/2015
Last updated
07/02/2015
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