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General NPI Number Information
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NPI Number | 1053367078
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Entity Type | Individual
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Provider Name | GRACE CLAIRE RIDDELL L.I.C.S.W., L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 3000 CONNECTICUT AVE NW SUITE 137
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City | WASHINGTON
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State | DC
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Zip | 20008-2509
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Country | US
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Telephone | 301-942-3237
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Fax | 301-942-2047
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Provider Business Mailing Address
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Address Line | 3000 CONNECTICUT AVENUE NW SUITE 137
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City | WASHINGTON
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State | DC
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Zip | 20008
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Country | US
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Telephone | 301-942-3237
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Fax | 301-942-2047
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC301378
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05523
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License Number State | MD
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