Provider Demographics
NPI:1740063882
Name:ENS PSYCHIATRY LLC
Entity type:Organization
Organization Name:ENS PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:SALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-396-0698
Mailing Address - Street 1:4209 URN ST
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5662
Mailing Address - Country:US
Mailing Address - Phone:234-759-9226
Mailing Address - Fax:
Practice Address - Street 1:1629 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1631
Practice Address - Country:US
Practice Address - Phone:330-396-0698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center