Healthcare Provider Details

I. General information

NPI: 1992965552
Provider Name (Legal Business Name): CAPITOLHILL CONSORTIUM FOR COUNSELING & CONSULTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PENNSYLVANIA AVE SE STE 440
WASHINGTON DC
20003-4424
US

IV. Provider business mailing address

650 PENNSYLVANIA AVE SE STE 440
WASHINGTON DC
20003-4424
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-5440
  • Fax: 202-544-3004
Mailing address:
  • Phone: 202-544-5440
  • Fax: 202-544-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1526
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM RICE
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 202-674-1227