1689710022 NPI number — WASHINGTON ASSESSMENT & THERAPY SERVICES

Table of content: (NPI 1689710022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689710022 NPI number — WASHINGTON ASSESSMENT & THERAPY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON ASSESSMENT & THERAPY 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:
6
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:
1689710022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-277-7800
Provider Business Mailing Address Fax Number:
301-942-4807

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3602 LITTLEDALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENSINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-277-7800
Provider Business Practice Location Address Fax Number:
301-942-4807
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WYNNE
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-588-8881

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 33486100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: MD04 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02644840 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02146030 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4382 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 98411050 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 328494 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 56851 . This is a "MAGELLAN EAP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7180237 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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