Provider Demographics
NPI:1588714059
Name:SALAS, PATRICIA LOUISE (LCSW-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:SALAS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 32ND ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1641
Mailing Address - Country:US
Mailing Address - Phone:202-966-7362
Mailing Address - Fax:202-966-4140
Practice Address - Street 1:1109 SPRING ST
Practice Address - Street 2:SUITE 612
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4002
Practice Address - Country:US
Practice Address - Phone:202-966-7362
Practice Address - Fax:202-966-4140
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health