Provider Demographics
NPI:1265580666
Name:CAROL E. ALTSTATT, LCSWC
Entity type:Organization
Organization Name:CAROL E. ALTSTATT, LCSWC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS COORDINATOR, WRAMC
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-782-7250
Mailing Address - Street 1:2 WRAMC RM 2J38
Mailing Address - Street 2:6900 GEORGIA AV NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20301-0001
Mailing Address - Country:US
Mailing Address - Phone:202-782-7250
Mailing Address - Fax:
Practice Address - Street 1:2 WRAMC RM 2J38
Practice Address - Street 2:6900 GEORGIA AV NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD062181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty