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General NPI Number Information
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NPI Number | 1497951347
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Entity Type | Organization
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Legal Business Name | DIVERSIFIED PSYCHOTHERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1420 N ST NW SUITE 102
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City | WASHINGTON
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State | DC
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Zip | 20005-2843
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Country | US
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Telephone | 202-483-0202
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Fax | 202-483-0211
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Provider Business Mailing Address
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Address Line | PO BOX 34632
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City | WASHINGTON
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State | DC
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Zip | 20043-4632
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Country | US
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Telephone | 202-483-0202
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Fax | 202-483-0211
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. ERIC N LEHOT
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Credential | LICSW, BCD
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Telephone | 202-483-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC303283
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License Number State | DC
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