Healthcare Provider Details

I. General information

NPI: 1477209112
Provider Name (Legal Business Name): CELESTINE LLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 MARION BARRY AVE SE
WASHINGTON DC
20020-5615
US

IV. Provider business mailing address

1418 GOOD HOPE RD SE
WASHINGTON DC
20020-5615
US

V. Phone/Fax

Practice location:
  • Phone: 22-796-5000
  • Fax:
Mailing address:
  • Phone: 202-796-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCACII200001261
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: