Healthcare Provider Details

I. General information

NPI: 1003464116
Provider Name (Legal Business Name): TECHNOTHERAPY PUBLIC BENEFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2019
Last Update Date: 09/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 BELMONT RD NW APT 312
WASHINGTON DC
20009-5414
US

IV. Provider business mailing address

2032 BELMONT RD NW APT 312
WASHINGTON DC
20009-5414
US

V. Phone/Fax

Practice location:
  • Phone: 202-250-1230
  • Fax:
Mailing address:
  • Phone: 202-250-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. VIKRAM SURYA CHIRUVOLU
Title or Position: FOUNDER & CEO
Credential: LGPC MA BSCS
Phone: 202-250-1230