Healthcare Provider Details

I. General information

NPI: 1699315788
Provider Name (Legal Business Name): AUDREY NEFF LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 14TH ST NW FL 5R
WASHINGTON DC
20005-3706
US

IV. Provider business mailing address

1525 14TH ST NW FL 5R
WASHINGTON DC
20005-3706
US

V. Phone/Fax

Practice location:
  • Phone: 240-988-8996
  • Fax:
Mailing address:
  • Phone: 202-444-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLC50081910
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50081910
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: