| NPI | 1790224038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE SHELTON Manager 202-734-4885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2026-02-25 |