Provider Demographics
NPI:1497895767
Name:ABRAMS, IRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10711 WEYMOUTH ST
Mailing Address - Street 2:P.O. BOX 475
Mailing Address - City:GARRETT PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20896-1519
Mailing Address - Country:US
Mailing Address - Phone:301-523-0477
Mailing Address - Fax:301-949-2098
Practice Address - Street 1:10711 WEYMOUTH ST
Practice Address - Street 2:
Practice Address - City:GARRETT PARK
Practice Address - State:MD
Practice Address - Zip Code:20896-1519
Practice Address - Country:US
Practice Address - Phone:301-523-0477
Practice Address - Fax:301-949-2098
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001685103TC0700X, 103T00000X
MD02557103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent