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General NPI Number Information
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NPI Number | 1154896157
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Entity Type | Individual
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Provider Name | JACK WERSTEIN MA, LPC
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Gender | Male
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1801 COLUMBIA RD NW STE 102
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City | WASHINGTON
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State | DC
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Zip | 20009-2031
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Country | US
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Telephone | 202-506-3240
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Fax |
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Provider Business Mailing Address
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Address Line | 4530 CONNECTICUT AVE NW APT 605
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City | WASHINGTON
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State | DC
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Zip | 20008-4315
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Country | US
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Telephone | 202-506-3240
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC15104
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License Number State | DC
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