Healthcare Provider Details

I. General information

NPI: 1750055760
Provider Name (Legal Business Name): CEYMONE DYCE PHD, LGPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 PENNSYLVANIA AVE SE # 415
WASHINGTON DC
20003-4303
US

IV. Provider business mailing address

2101 NEW HAMPSHIRE AVE NW APT 112
WASHINGTON DC
20009-6572
US

V. Phone/Fax

Practice location:
  • Phone: 888-878-8236
  • Fax:
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: