Provider Demographics
NPI:1598916728
Name:MONTROSE VIEW PSYCHOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:MONTROSE VIEW PSYCHOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:PERKINS
Authorized Official - Last Name:HAUCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-881-4884
Mailing Address - Street 1:6339 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3905
Mailing Address - Country:US
Mailing Address - Phone:301-881-4884
Mailing Address - Fax:301-881-5447
Practice Address - Street 1:6339 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3905
Practice Address - Country:US
Practice Address - Phone:301-881-4884
Practice Address - Fax:301-881-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2128103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD101600800Medicaid
MD101600800Medicaid