MEDICARE: BRING OUT THE JOY LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1912702358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRING OUT THE JOY LLC

Provider Business Mailing Address
First Line	:	3534 WARDER ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-1724
Country	:	US
Telephone Number	:	240-676-8796
Fax Number	:	202-217-4352

Provider Business Practice Location Address
First Line	:	3534 WARDER ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-1724
Country	:	US
Telephone Number	:	240-676-8796
Fax Number	:	202-217-4352

Authorized Official
Title or Position	:	OWNER
Name	:	MR. AARON LINWOOD FOOTMAN III
Credential	:
Telephone Number	:	240-676-8796

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/18/2025

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