Healthcare Provider Details

I. General information

NPI: 1447338397
Provider Name (Legal Business Name): COMPREHENSIVE COMMUNITY HEALTH & PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 H ST NE
WASHINGTON DC
20002-4445
US

IV. Provider business mailing address

1250 H ST NE
WASHINGTON DC
20002-4445
US

V. Phone/Fax

Practice location:
  • Phone: 202-543-5830
  • Fax: 202-543-5832
Mailing address:
  • Phone: 202-543-5830
  • Fax: 202-543-5832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LA VERNA SIMMS
Title or Position: PRESIDENT AND CEO
Credential: PH.D
Phone: 202-543-5830