Healthcare Provider Details

I. General information

NPI: 1619133311
Provider Name (Legal Business Name): ALDO U HURTADO LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 KENYON ST NW #212
WASHINGTON DC
20010-2398
US

IV. Provider business mailing address

1315 CONSTITUTION AVE NE #3
WASHINGTON DC
20002-6419
US

V. Phone/Fax

Practice location:
  • Phone: 202-319-2355
  • Fax:
Mailing address:
  • Phone: 301-755-7569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078267
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: