MEDICARE: LOURDES G CARAZO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	CACII1090	DC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CACII1090	DC

General Provider Information

NPI Number	:	1306532528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOURDES G CARAZO

Provider Business Mailing Address
First Line	:	3958 9TH RD S
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-4172
Country	:	US
Telephone Number	:	571-303-8494
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 KENNEDY ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-3137
Country	:	US
Telephone Number	:	202-223-9630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	02/06/2026

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Directions to “ LOURDES G CARAZO ” Practice Location

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