Provider Demographics
NPI:1003019852
Name:THE CAPITAL REGION CHILDREN'S CENTER
Entity Type:Organization
Organization Name:THE CAPITAL REGION CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NCC, LPC
Authorized Official - Phone:202-486-4409
Mailing Address - Street 1:PO BOX 15828
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20825-5828
Mailing Address - Country:US
Mailing Address - Phone:202-486-4409
Mailing Address - Fax:866-712-1080
Practice Address - Street 1:3414 MANOR RD
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5732
Practice Address - Country:US
Practice Address - Phone:202-486-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health