Healthcare Provider Details

I. General information

NPI: 1801332200
Provider Name (Legal Business Name): MARRIAGE AND FAMILY THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PENNSYLVANIA AVE NW # 272
WASHINGTON DC
20006-1811
US

IV. Provider business mailing address

2020 PENNSYLVANIA AVE NW # 272
WASHINGTON DC
20006-1811
US

V. Phone/Fax

Practice location:
  • Phone: 202-569-8845
  • Fax:
Mailing address:
  • Phone: 202-569-8845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT000177
License Number StateDC

VIII. Authorized Official

Name: DANIELLE BLESSING TAYLOR
Title or Position: OWNER
Credential:
Phone: 202-569-8845