Healthcare Provider Details

I. General information

NPI: 1144839671
Provider Name (Legal Business Name): KEEPING THERAPY CLOSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 M ST SE STE 600
WASHINGTON DC
20003-3648
US

IV. Provider business mailing address

100 M ST SE STE 600
WASHINGTON DC
20003-3648
US

V. Phone/Fax

Practice location:
  • Phone: 202-503-4485
  • Fax:
Mailing address:
  • Phone: 202-503-4485
  • 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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TENNILLE HARRIS
Title or Position: CO-OWNER/THERAPIST
Credential: LPC
Phone: 202-503-4485