Provider Demographics
NPI:1629549670
Name:WASHINGTON CENTER FOR PERSONAL GROWTH, LLC
Entity Type:Organization
Organization Name:WASHINGTON CENTER FOR PERSONAL GROWTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABZUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-541-8072
Mailing Address - Street 1:817 SILVER SPRING AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4617
Mailing Address - Country:US
Mailing Address - Phone:301-960-8991
Mailing Address - Fax:
Practice Address - Street 1:817 SILVER SPRING AVE STE 408
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4617
Practice Address - Country:US
Practice Address - Phone:301-960-8991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center