Provider Demographics
NPI:1346461167
Name:LADISCH, BRIGITTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIGITTE
Middle Name:
Last Name:LADISCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 PICKWICK LN
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4042
Mailing Address - Country:US
Mailing Address - Phone:301-654-2124
Mailing Address - Fax:301-652-6250
Practice Address - Street 1:2000 P ST NW
Practice Address - Street 2:SUITE 710
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5915
Practice Address - Country:US
Practice Address - Phone:301-654-2124
Practice Address - Fax:301-652-6250
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1899103T00000X
MD02903103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist