Provider Demographics
NPI:1841521416
Name:MINDWELL PSYCHOLOGY BETHESDA
Entity type:Organization
Organization Name:MINDWELL PSYCHOLOGY BETHESDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:BISHOP
Authorized Official - Last Name:RESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:301-581-1120
Mailing Address - Street 1:5602 SHIELDS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3571
Mailing Address - Country:US
Mailing Address - Phone:301-581-1120
Mailing Address - Fax:301-581-1122
Practice Address - Street 1:5602 SHIELDS DR
Practice Address - Street 2:SUITE A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3571
Practice Address - Country:US
Practice Address - Phone:301-581-1120
Practice Address - Fax:301-581-1122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINDWELL PSYCHOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04559103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty