Provider Demographics
NPI:1124642228
Name:BETHESDA PSYCHOLOGICAL EVALUATIONS AND TREATMENT LIMITED
Entity type:Organization
Organization Name:BETHESDA PSYCHOLOGICAL EVALUATIONS AND TREATMENT LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-246-0436
Mailing Address - Street 1:4300 MONTGOMERY AVE STE 104B
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 MONTGOMERY AVE STE 104
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4412
Practice Address - Country:US
Practice Address - Phone:301-246-0436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health