Healthcare Provider Details

I. General information

NPI: 1457915472
Provider Name (Legal Business Name): AALIYAH MUHAMMAD LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2759 MARTIN LUTHER KING JR AVE SE STE 301
WASHINGTON DC
20032-2651
US

IV. Provider business mailing address

5932 9TH ST NW APT 11
WASHINGTON DC
20011-1929
US

V. Phone/Fax

Practice location:
  • Phone: 202-827-9961
  • Fax: 202-827-9963
Mailing address:
  • Phone: 504-236-2982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50080280
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: