Provider Demographics
NPI:1316060510
Name:STOLTZ, BERNARD ADAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:ADAM
Last Name:STOLTZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 S ST NW
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6107
Mailing Address - Country:US
Mailing Address - Phone:202-234-7738
Mailing Address - Fax:202-234-7778
Practice Address - Street 1:1755 S ST NW
Practice Address - Street 2:SUITE 6B
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6107
Practice Address - Country:US
Practice Address - Phone:202-234-7738
Practice Address - Fax:202-234-7778
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY100402103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical