Provider Demographics
NPI:1336954684
Name:CAPITAL CHILDREN'S WELLNESS CENTER
Entity type:Organization
Organization Name:CAPITAL CHILDREN'S WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIZEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, RPT
Authorized Official - Phone:202-374-6717
Mailing Address - Street 1:8618 WILD OLIVE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3438
Mailing Address - Country:US
Mailing Address - Phone:202-374-6717
Mailing Address - Fax:
Practice Address - Street 1:8618 WILD OLIVE DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3438
Practice Address - Country:US
Practice Address - Phone:202-374-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health