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General NPI Number Information
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NPI Number | 1346737079
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Entity Type | Organization
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Legal Business Name | EHC THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 113 S WEST ST STE 204
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2851
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Country | US
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Telephone | 202-618-0754
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Fax |
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Provider Business Mailing Address
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Address Line | 701 BRANDYWINE ST SE APT 101
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City | WASHINGTON
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State | DC
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Zip | 20032-3551
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Country | US
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Telephone | 202-629-3026
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | ELIA HEIDIANN CHARLES
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Credential | LICSW
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Telephone | 202-618-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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