Healthcare Provider Details

I. General information

NPI: 1801487764
Provider Name (Legal Business Name): BERNADETTE LATRICIA BOOZER-MADISON PHD, MSW, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 F ST NW STE 301
WASHINGTON DC
20004-1140
US

IV. Provider business mailing address

1319 F ST NW STE 301
WASHINGTON DC
20004-1140
US

V. Phone/Fax

Practice location:
  • Phone: 202-810-3439
  • Fax: 301-560-8141
Mailing address:
  • Phone: 202-810-3439
  • Fax: 301-560-8141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT000034
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: