Healthcare Provider Details

I. General information

NPI: 1174415483
Provider Name (Legal Business Name): JENA TULIN BUCHHOLZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 01/17/2026
Certification Date: 01/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 G ST NW STE 800
WASHINGTON DC
20005-6705
US

IV. Provider business mailing address

2007 O ST NW APT 505
WASHINGTON DC
20036-5937
US

V. Phone/Fax

Practice location:
  • Phone: 614-314-7547
  • Fax:
Mailing address:
  • Phone: 614-314-7547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003606
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017644
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2507234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: