Healthcare Provider Details

I. General information

NPI: 1134706260
Provider Name (Legal Business Name): FARNAZ YAZHARI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 F ST NW
WASHINGTON DC
20037-2715
US

IV. Provider business mailing address

650 PENNSYLVANIA AVE SE STE 440
WASHINGTON DC
20003-4424
US

V. Phone/Fax

Practice location:
  • Phone: 202-349-3218
  • Fax: 202-822-9130
Mailing address:
  • Phone: 202-544-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200001267
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: