Healthcare Provider Details

I. General information

NPI: 1609639129
Provider Name (Legal Business Name): PLENA COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 CHILLUM PL NE
WASHINGTON DC
20011-2620
US

IV. Provider business mailing address

5325 CHILLUM PL NE
WASHINGTON DC
20011-2620
US

V. Phone/Fax

Practice location:
  • Phone: 202-670-8285
  • Fax:
Mailing address:
  • Phone: 202-300-6847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EVELYN IRAHETA
Title or Position: OWNER
Credential: LPC
Phone: 202-300-6847