Healthcare Provider Details

I. General information

NPI: 1922870245
Provider Name (Legal Business Name): BRIANNE LANDWERSIEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 NEW YORK AVE NW
WASHINGTON DC
20005-4701
US

IV. Provider business mailing address

1445 OTIS PL NW APT 327
WASHINGTON DC
20010-3209
US

V. Phone/Fax

Practice location:
  • Phone: 202-737-6191
  • Fax:
Mailing address:
  • Phone: 315-391-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC200001851
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: