Healthcare Provider Details

I. General information

NPI: 1669365185
Provider Name (Legal Business Name): EVERY BODY PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 42ND ST NW STE 307
WASHINGTON DC
20016-4623
US

IV. Provider business mailing address

4545 42ND ST NW STE 307
WASHINGTON DC
20016-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-556-4435
  • Fax:
Mailing address:
  • Phone: 202-556-4435
  • 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 Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: HEATHER CLARK
Title or Position: OWNER
Credential: LPC, LCPC, CBTP
Phone: 202-556-4435