Healthcare Provider Details

I. General information

NPI: 1710367396
Provider Name (Legal Business Name): JOAN PRINCE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 NEW YORK AVE NW
WASHINGTON DC
20005-4701
US

IV. Provider business mailing address

1313 NEW YORK AVE NW
WASHINGTON DC
20005-4701
US

V. Phone/Fax

Practice location:
  • Phone: 202-737-6171
  • Fax:
Mailing address:
  • Phone: 202-737-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14669
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: