Healthcare Provider Details

I. General information

NPI: 1467606038
Provider Name (Legal Business Name): MARGARET (MARI) GRAHAM CLEMSON-HINES LMFT DC000159 CA5148
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET (MARI) GRAHAM CLEMSON LMFT

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 CONNECTICUT AVE SUITE #300
WASHINGTON DC
20009
US

IV. Provider business mailing address

1801 CONNECTICUT AVE SUITE #300
WASHINGTON DC
20009
US

V. Phone/Fax

Practice location:
  • Phone: 202-440-3302
  • Fax:
Mailing address:
  • Phone: 202-440-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT0000159
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC51483
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717001422
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: