Healthcare Provider Details

I. General information

NPI: 1336493022
Provider Name (Legal Business Name): CENTER CITY PUBLIC CHARTER SCHOOLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 NEW YORK AVE NE STE. 300
WASHINGTON DC
20002-3325
US

IV. Provider business mailing address

7 NEW YORK AVE NE STE. 300
WASHINGTON DC
20002-3325
US

V. Phone/Fax

Practice location:
  • Phone: 202-589-0202
  • Fax: 202-589-1629
Mailing address:
  • Phone: 202-589-0202
  • Fax: 202-589-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateDC

VIII. Authorized Official

Name: DR. MARJORIE LLOYD
Title or Position: CHEIF ACADEMIC OFFICER
Credential: M. ED
Phone: 202-589-0202