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Organization

GREEN DOOR BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD BEBOUT PH.D. (CEO)
(202) 464-9200
Entity
Organization

Contact information

Practice address
1221 TAYLOR ST NW, WASHINGTON, DC 20011-5617
(202) 464-9200
(202) 464-5740
Mailing address
1221 TAYLOR ST NW, WASHINGTON, DC 20011-5617
(202) 464-9200
(202) 464-5740

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
251B00000X
Case Management Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
54000690
DC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
DC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036561200
DC
05
057062300
DC
Enumeration date
03/05/2007
Last updated
05/05/2016
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