Healthcare Provider Details

I. General information

NPI: 1710049309
Provider Name (Legal Business Name): JOE TRUELOVE LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

8852 BEAVERCREEK LN
GAITHERSBURG MD
20879-1735
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-6378
  • Fax:
Mailing address:
  • Phone: 301-670-4264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: