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General NPI Number Information
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NPI Number | 1285978080
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Entity Type | Organization
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Legal Business Name | NATIONAL COLLEGIATE PREPARATORY PCHS
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 4600 LIVINGSTON RD SE NATIONAL COLLEGIATE PREPARTORY PCHS
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City | WASHINGTON
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State | DC
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Zip | 20032-4098
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Country | US
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Telephone | 202-832-7737
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Fax | 202-832-7736
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Provider Business Mailing Address
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Address Line | 4600 LIVINGSTON RD SE NATIONAL COLLEGIATE PREPARTORY PCHS
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City | WASHINGTON
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State | DC
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Zip | 20032-4098
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Country | US
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Telephone | 202-832-7737
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Fax | 202-832-7736
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JENNIFER ROSS
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Credential |
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Telephone | 202-832-7737
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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 | PRC14026
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY1000323
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP000442
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | LC50078330
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License Number State | DC
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