Provider Demographics
NPI:1457532293
Name:CENTRAL WASHINGTON PSYCHOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:CENTRAL WASHINGTON PSYCHOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHEAVLY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, DCSW
Authorized Official - Phone:202-232-4900
Mailing Address - Street 1:1700 17TH ST NW APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2419
Mailing Address - Country:US
Mailing Address - Phone:202-232-4900
Mailing Address - Fax:202-250-7990
Practice Address - Street 1:1700 17TH ST NW APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2419
Practice Address - Country:US
Practice Address - Phone:202-232-4900
Practice Address - Fax:202-250-7990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0008291102L00000X
DCLC003022411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty