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General NPI Number Information
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NPI Number | 1104471846
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Entity Type | Organization
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Legal Business Name | WITHOUT WALLS COUNSELING CENTER
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 2121 EISENHOWER AVE STE 301
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4688
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Country | US
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Telephone | 202-657-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 316 LISMORE DR
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHANTAY WHITE-
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Credential |
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Telephone | 253-576-8514
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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 |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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