Healthcare Provider Details

I. General information

NPI: 1285546465
Provider Name (Legal Business Name): HEAVY IS THE HEAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW
WASHINGTON DC
20006-1602
US

IV. Provider business mailing address

2657G ANNAPOLIS RD STE 202
HANOVER MD
21076-2467
US

V. Phone/Fax

Practice location:
  • Phone: 215-688-2547
  • Fax:
Mailing address:
  • Phone: 215-688-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. NIJIA MONAE WILLIAMS
Title or Position: CEO
Credential: MSW, LGSW
Phone: 215-688-2547