Basic Information
| Provider Information | |||||||||
| NPI: | 1265580666 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROL E. ALTSTATT, LCSWC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 WRAMC RM 2J38 | ||||||||
| Address2: | 6900 GEORGIA AV NW | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 203010001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027827250 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 WRAMC RM 2J38 | ||||||||
| Address2: | 6900 GEORGIA AV NW | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 203070001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027827250 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CONTRERAS | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALS COORDINATOR, WRAMC | ||||||||
| AuthorizedOfficialTelephone: | 2027827250 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 06218 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.