Organization
COMMUNITY CLINIC, INC
Active
Organization
COMMUNITY CLINIC, INC
Active
Other names
CCI
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA J BRUTON (PHD.PSY.D- CLINICAL PSYCHOLOGISTCEO)
(240) 839-5107
Entity
Organization
Contact information
Practice address
8630 FENTON ST STE 1200, SILVER SPRING, MD 20910-3808
(301) 585-1250
(301) 585-6289
Mailing address
8665 GEORGIA AVE, SILVER SPRING, MD 20910-3405
(301) 340-7525
(301) 495-0318
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130061003
—
MD
Enumeration date
02/21/2007
Last updated
12/13/2024
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