Healthcare Provider Details

I. General information

NPI: 1861031114
Provider Name (Legal Business Name): SONIA HARISH KOTECHA LICSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2020
Last Update Date: 01/04/2020
Certification Date: 01/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

1400 E WEST HWY APT 804
SILVER SPRING MD
20910-6217
US

V. Phone/Fax

Practice location:
  • Phone: 202-697-3772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number36956
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078139
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: