Healthcare Provider Details
I. General information
NPI: 1497141246
Provider Name (Legal Business Name): DC HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2015
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4545 42ND ST NW STE 200
WASHINGTON DC
20016-4623
US
IV. Provider business mailing address
4545 42ND ST NW STE 200
WASHINGTON DC
20016-4623
US
V. Phone/Fax
- Phone: 202-413-4431
- Fax:
- Phone: 202-413-4431
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
DIANE
SHEAHAN
Title or Position: DIRECTOR
Credential: PHD, LICSW
Phone: 202-413-4431