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General NPI Number Information
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NPI Number | 1356864292
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Entity Type | Organization
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Legal Business Name | A FAMILY FRIEND LLC
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1901 PENNSYLVANIA AVE NW STE 602
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City | WASHINGTON
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State | DC
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Zip | 20006-3405
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Country | US
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Telephone | 301-758-6562
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 PENNSYLVANIA AVE NW STE 602
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City | WASHINGTON
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State | DC
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Zip | 20006-3405
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Country | US
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Telephone | 301-758-6562
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Fax |
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Authorized Official
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Title or Position | LPC (OWNER)
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Name | MR. ALEXANDER L GORODETSKY
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Credential | MA
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Telephone | 301-758-6562
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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 | PRC14285
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License Number State | DC
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