Healthcare Provider Details

I. General information

NPI: 1306584628
Provider Name (Legal Business Name): WELLNESS RESTORATION COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

V. Phone/Fax

Practice location:
  • Phone: 202-427-3996
  • Fax:
Mailing address:
  • Phone: 202-427-3996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARYLIN MARQUEZ BECKLEY
Title or Position: FOUNDER & CEO
Credential: MA, LPC, NCC
Phone: 202-427-3996