Provider Demographics
NPI:1962678789
Name:CAPITAL AREA PSYCHIATRIC SVC.
Entity type:Organization
Organization Name:CAPITAL AREA PSYCHIATRIC SVC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HEMANJANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GONCHIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:301-461-6961
Mailing Address - Street 1:44121 LESSBURG PIKE
Mailing Address - Street 2:STE 250
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5674
Mailing Address - Country:US
Mailing Address - Phone:703-831-4207
Mailing Address - Fax:703-430-9785
Practice Address - Street 1:2235 CEDAR LN STE 302
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5247
Practice Address - Country:US
Practice Address - Phone:703-889-5406
Practice Address - Fax:703-430-9785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD663910100Medicaid
DCG01144Medicare PIN