Providence Hospital is a Health Service - Psychology Clinic in Washington, District Of Columbia. This organization is also known as sub part of Providence Hospital. It is located at 1160 Varnum St Ne, Washington, DC and its contact number is 202-854-7000. The authorized person for Providence Hospital is Mr. Mitchell Lomax
who is Vice President/cfo of the clinic and his/her contact number is 667-234-2926. Providence Hospital Clinic is certified/licensed at the independent practice level in his/her state, and is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Complete Clinic Profile:
Providence Hospital Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Providence Hospital
Specialization:
Health Service Psychology
Clinic Address:
1160 Varnum St Ne, Washington, District Of Columbia, 20017-2107
Phone:
202-854-7000
Fax:
202-269-7160
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Mitchell Lomax
Position:
Vice President/cfo
Contact Number:
667-234-2926
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Providence Hospital clinic are as mentioned below.
NPI Number:
1669453809
Parent Organization:
Providence Hospital
NPI Enumeration Date:
06 Nov, 2005
NPI Last Update On:
01 Nov, 2023
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Hospital are as mentioned below.
Specialization
License Number
State
Status
Family Medicine
Primary
Health Service
Secondary
Internal Medicine
Secondary
Surgery
Secondary
Hospitalist
Secondary
Case Management
HFD01-0212
District Of Columbia
Secondary
Nurse Practitioner
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
023435102
Medicaid
District Of Columbia
023435100
Medicaid
District Of Columbia
080352200
Medicaid
District Of Columbia
5485215 00
Medicaid
District Of Columbia
023435101
Medicaid
Maryland
5485215 01
Medicaid
Maryland
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Providence Hospital 1150 Varnum St Ne, Administration 4th Floor Washington, District Of Columbia
Zip:
20017-2149
Phone Number:
202-854-4255
Fax Number:
202-854-7160
Patients can reach Providence Hospital at 1160 Varnum St Ne, Washington, District Of Columbia or can call to book an appointment on 202-854-7000. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.