Healthcare Provider Details

I. General information

NPI: 1659266856
Provider Name (Legal Business Name): INVIGOR THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N ST NW STE 1
WASHINGTON DC
20036-2827
US

IV. Provider business mailing address

602 CHANCE PL
CAPITOL HEIGHTS MD
20743-3200
US

V. Phone/Fax

Practice location:
  • Phone: 434-228-0580
  • Fax:
Mailing address:
  • Phone: 202-750-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAREN A GILLISON
Title or Position: OWNER
Credential:
Phone: 202-750-0567