Healthcare Provider Details

I. General information

NPI: 1669337556
Provider Name (Legal Business Name): NATASHA STEPHENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5717 DIX ST NE # 315
WASHINGTON DC
20019-6918
US

IV. Provider business mailing address

5717 DIX ST NE # 315
WASHINGTON DC
20019-6918
US

V. Phone/Fax

Practice location:
  • Phone: 240-639-3439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: