Provider Demographics
NPI:1457749616
Name:CATHOLIC FAMILY CLINICIAN NETWORK
Entity type:Organization
Organization Name:CATHOLIC FAMILY CLINICIAN NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-767-1733
Mailing Address - Street 1:7007 BRADLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2149
Mailing Address - Country:US
Mailing Address - Phone:301-767-1733
Mailing Address - Fax:301-767-1743
Practice Address - Street 1:7007 BRADLEY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2149
Practice Address - Country:US
Practice Address - Phone:301-767-1733
Practice Address - Fax:301-767-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6097251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health