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General NPI Number Information
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NPI Number | 1639666969
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Entity Type | Organization
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Legal Business Name | CRONE ESQUIVEL GROUP
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 1400 20TH ST NW STE 104
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City | WASHINGTON
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State | DC
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Zip | 20036-5963
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Country | US
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Telephone | 703-300-0526
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 15TH ST NW STE 334
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City | WASHINGTON
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State | DC
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Zip | 20005-1502
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Country | US
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Telephone | 617-981-4910
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JAMAAL ALFONZO CRONE
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Credential | LPC
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Telephone | 617-981-4910
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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 | PRC14956
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License Number State | DC
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