Provider Demographics
NPI:1689710022
Name:WASHINGTON ASSESSMENT & THERAPY SERVICES
Entity Type:Organization
Organization Name:WASHINGTON ASSESSMENT & THERAPY SERVICES
Other - Org Name:RONALD D WYNNE PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WYNNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-588-8881
Mailing Address - Street 1:PO BOX 1104
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20911
Mailing Address - Country:US
Mailing Address - Phone:240-277-7800
Mailing Address - Fax:301-942-4807
Practice Address - Street 1:3602 LITTLEDALE RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895
Practice Address - Country:US
Practice Address - Phone:240-277-7800
Practice Address - Fax:301-942-4807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD33486100Medicaid
DCMD04Medicaid
DC02644840Medicaid
DC02146030Medicaid
4382OtherCAREFIRST
MD98411050Medicaid
328494OtherMANAGED HEALTH NETWORK
56851OtherMAGELLAN EAP
7180237OtherAETNA
DC02146030Medicaid
4382OtherCAREFIRST