Provider Demographics
NPI:1023376407
Name:GEORGETOWN PSYCHOLOGY, P.C.
Entity Type:Organization
Organization Name:GEORGETOWN PSYCHOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMITTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-333-6251
Mailing Address - Street 1:8120 WOODMONT AVE STE 660
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2743
Mailing Address - Country:US
Mailing Address - Phone:301-652-5550
Mailing Address - Fax:
Practice Address - Street 1:1054 31ST ST NW STE 312
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-6042
Practice Address - Country:US
Practice Address - Phone:202-333-6251
Practice Address - Fax:202-333-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1940103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPSY1001390OtherSTATE LICENSE
VA0904009819OtherSTATE LICENSE
DCPSY1001328OtherSTATE LICENSE
DCPSY1000990OtherSTATE LICENSE
DCPSY1001244OtherSTATE LICENSE
VA0810005759OtherSTATE LICENSE
PSY1000895OtherSTATE LICENSE
DCLC5008240OtherSTATE LICENSE
MD07177OtherSTATE LICENSE
MD05734OtherSTATE LICENSE
DCPSY1940OtherSTATE LICENSE