Provider Demographics
NPI:1588769855
Name:ALTMAN, BETH L (MSW LICSW)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:L
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 17TH ST NW
Mailing Address - Street 2:SUITE 1015
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-686-6307
Mailing Address - Fax:202-686-1185
Practice Address - Street 1:910 17TH ST NW
Practice Address - Street 2:SUITE 1015
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-686-6307
Practice Address - Fax:202-686-1185
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC00300469103T00000X, 1041C0700X
MD2944103T00000X
MD28441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
646481Medicare ID - Type Unspecified