1083062467 NPI number — METROPOLITAN CENTER FOR PSYCHOLOGICAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083062467 NPI number — METROPOLITAN CENTER FOR PSYCHOLOGICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN CENTER FOR PSYCHOLOGICAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083062467
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401A CONNECTICUT AVE NW
Provider Second Line Business Mailing Address:
STE. 171
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20008-2358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-596-2258
Provider Business Mailing Address Fax Number:
202-806-7299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1629 K ST NW
Provider Second Line Business Practice Location Address:
STE. 300
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20006-1602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-596-2258
Provider Business Practice Location Address Fax Number:
202-806-7299
Provider Enumeration Date:
05/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HUMMINGS
Authorized Official First Name:
MARCUS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
202-596-2258

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  0810004927 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY1000822 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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