| NPI | 1396124038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERIESHA JANELL HODGE Owner 202-531-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LC6401) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 101Y00000X Counselor (Licence: MD LC6401) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC6401) | |
| 101YM0800X Counselor, Mental Health (Licence: MD LC6401) | |
| 101YP2500X Counselor, Professional (Licence: MD LC6401) | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2019-02-12 |