Healthcare Provider Details

I. General information

NPI: 1396678777
Provider Name (Legal Business Name): CARA GORMALLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CK GORMALLY

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 UNION ST NE
WASHINGTON DC
20002-7042
US

IV. Provider business mailing address

1255 UNION ST NE
WASHINGTON DC
20002-7042
US

V. Phone/Fax

Practice location:
  • Phone: 202-670-0083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200006913
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34820
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: