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General NPI Number Information
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NPI Number | 1457808909
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Entity Type | Organization
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Legal Business Name | KASVU COUNSELING, PLLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1350 CONNECTICUT AVE NW STE 612
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City | WASHINGTON
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State | DC
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Zip | 20036-1735
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Country | US
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Telephone | 202-656-0258
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 CONNECTICUT AVE NW STE 612
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City | WASHINGTON
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State | DC
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Zip | 20036-1735
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Country | US
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Telephone | 202-656-0258
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DAVIN MAIJALA
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Credential | PSYD
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Telephone | 202-656-0258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1001024
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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 | PSY1001024
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License Number State | DC
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