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General NPI Number Information
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NPI Number | 1073095089
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Entity Type | Organization
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Legal Business Name | KOVU HEALING
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 1629 K ST NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20006-1631
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Country | US
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Telephone | 202-780-5887
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Fax |
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Provider Business Mailing Address
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Address Line | 116 STEEPLE CHASE WAY APT 116E
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-1137
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Country | US
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Telephone | 651-485-9379
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD THERAPIST
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Name | MS. APRIL PRESTON
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Credential | LMFT
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Telephone | 202-780-5887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LMFT000172
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License Number State | DC
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