Provider Demographics
NPI:1528675212
Name:PSYCHOTHERAPY ASSOCIATES OF THE DMV
Entity type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF THE DMV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ELLSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:571-317-1003
Mailing Address - Street 1:1700 CONNECTICUT AVE NW STE 401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1169
Mailing Address - Country:US
Mailing Address - Phone:703-568-6763
Mailing Address - Fax:888-220-4899
Practice Address - Street 1:1700 CONNECTICUT AVE NW STE 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1169
Practice Address - Country:US
Practice Address - Phone:571-317-1003
Practice Address - Fax:888-220-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty