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General NPI Number Information
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NPI Number | 1932769866
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Entity Type | Individual
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Provider Name | PHALANDE JEAN MFT, LGPC
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Gender | Female
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 1818 N ST NW STE 315
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City | WASHINGTON
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State | DC
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Zip | 20036-2594
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Country | US
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Telephone | 202-893-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 5597 SEMINARY RD APT 2406S
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2922
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Country | US
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Telephone | 954-857-5908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LGPC00577
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License Number State | VA
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