Provider Demographics
NPI:1871288407
Name:JOHN D KOTLER PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:JOHN D KOTLER PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KOTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LICSW
Authorized Official - Phone:301-785-9490
Mailing Address - Street 1:5480 WISCONSIN AVE STE 227
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3500
Mailing Address - Country:US
Mailing Address - Phone:301-785-9490
Mailing Address - Fax:301-493-4981
Practice Address - Street 1:5480 WISCONSIN AVE STE 227
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3500
Practice Address - Country:US
Practice Address - Phone:301-785-9490
Practice Address - Fax:301-493-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty