Provider Demographics
NPI:1346361441
Name:CORRADO, BRIAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:CORRADO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7988 OLD GEORGETOWN RD
Mailing Address - Street 2:8A
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2481
Mailing Address - Country:US
Mailing Address - Phone:301-718-4544
Mailing Address - Fax:301-718-4545
Practice Address - Street 1:7988 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 8A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2481
Practice Address - Country:US
Practice Address - Phone:301-718-4544
Practice Address - Fax:301-718-4545
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04249103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD012913500Medicaid
MD012913501Medicaid