Healthcare Provider Details

I. General information

NPI: 1386398295
Provider Name (Legal Business Name): ZAKIYYAH FRANCISCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 CARROLL AVE
TAKOMA PARK MD
20912-7707
US

IV. Provider business mailing address

9694 HALSTEAD AVE
LAUREL MD
20723-1882
US

V. Phone/Fax

Practice location:
  • Phone: 240-750-7604
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZAKIYYAH FRANCISCO
Title or Position: THERAPIST
Credential: LCSW-C
Phone: 240-750-7604