Healthcare Provider Details

I. General information

NPI: 1568185205
Provider Name (Legal Business Name): ZACHARY KHOURY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PENNSYLVANIA AVE SE STE 440
WASHINGTON DC
20003-4424
US

IV. Provider business mailing address

1608 15TH ST NW BSMT
WASHINGTON DC
20009-3802
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-5440
  • Fax:
Mailing address:
  • Phone: 843-670-5743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200002070
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: