Provider Demographics
NPI:1699959338
Name:ISENBERG, STACIE BETH (PSYD)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:BETH
Last Name:ISENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 400 THE ROSS CENTER
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015
Mailing Address - Country:US
Mailing Address - Phone:202-363-1010
Mailing Address - Fax:202-363-2383
Practice Address - Street 1:5225 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 400 THE ROSS CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015
Practice Address - Country:US
Practice Address - Phone:202-363-1010
Practice Address - Fax:202-363-2383
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000173103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist