Healthcare Provider Details

I. General information

NPI: 1376053058
Provider Name (Legal Business Name): ARKILAH WOMACK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 M ST SE
WASHINGTON DC
20003-3609
US

IV. Provider business mailing address

1810 SAVANNAH ST SE APT 202
WASHINGTON DC
20020-7501
US

V. Phone/Fax

Practice location:
  • Phone: 202-547-3870
  • Fax:
Mailing address:
  • Phone: 202-460-1637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14945
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: