Healthcare Provider Details

I. General information

NPI: 1801684253
Provider Name (Legal Business Name): MYTHERAPIST DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW
WASHINGTON DC
20006-1602
US

IV. Provider business mailing address

6517 SPRINGCREST DR
GREENBELT MD
20770-3059
US

V. Phone/Fax

Practice location:
  • Phone: 202-780-6101
  • Fax:
Mailing address:
  • Phone: 202-531-9423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. RASHIDA CLEGG
Title or Position: OWNER
Credential:
Phone: 202-531-9423