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General NPI Number Information
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NPI Number | 1629226451
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Entity Type | Organization
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Legal Business Name | LEPHOENIX HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 650 PENNSYLVANIA AVE SE SUITE 480
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City | WASHINGTON
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State | DC
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Zip | 20003-4318
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Country | US
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Telephone | 202-466-1640
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1749
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City | WASHINGTON
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State | DC
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Zip | 20013-1749
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Country | US
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Telephone | 202-466-1640
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. LAVERNE V. DANFORTH
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Credential | L.I.C.S.W.
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Telephone | 202-466-1640
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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 | LC302687
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License Number State | DC
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