Provider Demographics
NPI:1821306358
Name:BETHESDA BEHAVIORAL SCIENCES, P.C.
Entity Type:Organization
Organization Name:BETHESDA BEHAVIORAL SCIENCES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KNABLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-652-6260
Mailing Address - Street 1:4300 MONTGOMERY AVE
Mailing Address - Street 2:SUITE 304A
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4412
Mailing Address - Country:US
Mailing Address - Phone:301-652-6260
Mailing Address - Fax:301-652-6320
Practice Address - Street 1:4300 MONTGOMERY AVE
Practice Address - Street 2:SUITE 304A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4412
Practice Address - Country:US
Practice Address - Phone:301-652-6260
Practice Address - Fax:301-652-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH373022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty