Provider Demographics
NPI:1447455894
Name:SHMUELI, ADI (PHD)
Entity type:Individual
Prefix:DR
First Name:ADI
Middle Name:
Last Name:SHMUELI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9021 ALTON PKWY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2716
Mailing Address - Country:US
Mailing Address - Phone:301-495-5894
Mailing Address - Fax:
Practice Address - Street 1:1612 K ST NW
Practice Address - Street 2:SUITE 1202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2802
Practice Address - Country:US
Practice Address - Phone:202-463-8828
Practice Address - Fax:202-463-0701
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY727103TA0700X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily