Provider Demographics
NPI:1710106323
Name:OGDEN, RICHARD LESLIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LESLIE
Last Name:OGDEN
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 1:11112 WAYCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3217
Mailing Address - Country:US
Mailing Address - Phone:301-537-7570
Mailing Address - Fax:
Practice Address - Street 1:4400 EAST-WEST HWY
Practice Address - Street 2:SUITE 1028
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4524
Practice Address - Country:US
Practice Address - Phone:301-986-5499
Practice Address - Fax:301-907-3241
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01297103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical