Healthcare Provider Details

I. General information

NPI: 1437004074
Provider Name (Legal Business Name): IVAN ROBERTS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 ROCK CREEK CHURCH RD NW
WASHINGTON DC
20010-1617
US

IV. Provider business mailing address

7604 VICAR PL MARYLAND
NEW CARROLLTON MD
20784-2966
US

V. Phone/Fax

Practice location:
  • Phone: 202-696-7183
  • Fax:
Mailing address:
  • Phone: 202-696-7183
  • 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 Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA K RODNEY
Title or Position: CEO
Credential: PHD HOLISTIC WELLNES
Phone: 202-696-7183