Healthcare Provider Details

I. General information

NPI: 1760952816
Provider Name (Legal Business Name): SAQUEITA RUSSELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 H ST NE
WASHINGTON DC
20002-5678
US

IV. Provider business mailing address

315 H ST NE
WASHINGTON DC
20002-5678
US

V. Phone/Fax

Practice location:
  • Phone: 703-662-0277
  • Fax:
Mailing address:
  • Phone: 36-620-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC15433
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC00430
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: