Healthcare Provider Details

I. General information

NPI: 1790473627
Provider Name (Legal Business Name): NEGAR GHAFFARI LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

IV. Provider business mailing address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-7697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC11614
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: