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General NPI Number Information
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NPI Number | 1649924432
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Entity Type | Organization
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Legal Business Name | MULTICULTURAL CAREER CENTER, LLC
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 6000 EDSALL RD APT 103
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City | ALEXANDRIA
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State | VA
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Zip | 22304-5800
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Country | US
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Telephone | 571-350-3779
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Fax |
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Provider Business Mailing Address
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Address Line | 1602 BELLE VIEW BLVD # 5069
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City | ALEXANDRIA
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State | VA
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Zip | 22307-6531
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Country | US
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Telephone | 571-350-3779
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERTO CARLOS MARTINEZ
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Credential | LPC
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Telephone | 571-528-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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