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General NPI Number Information
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NPI Number | 1841837036
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Entity Type | Organization
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Legal Business Name | AFFIRMATIVE SPACES PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 1200 G ST NW STE 800
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City | WASHINGTON
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State | DC
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Zip | 20005-6705
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Country | US
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Telephone | 202-770-7067
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Fax |
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Provider Business Mailing Address
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Address Line | 82 I ST SE APT 1307
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City | WASHINGTON
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State | DC
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Zip | 20003-3793
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Country | US
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Telephone | 678-777-4036
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CLINICAL DIRECTOR
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Name | DR. ANTOINE L. CROSBY
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Credential | PHD
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Telephone | 202-770-7067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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