MEDICARE: DUBOIS PSYCHOLOGICAL & CONSULTING SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1154070142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUBOIS PSYCHOLOGICAL & CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	6218 GEORGIA AVE NW STE 1-708
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-5125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 PENNSYLVANIA AVE NW STE 200
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-5823
Country	:	US
Telephone Number	:	703-520-4118
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. CHELITA DUBOIS
Credential	:	PSY.D.
Telephone Number	:	703-520-4118

Provider Enumeration Date	:	03/18/2022
Last Update Date	:	03/18/2022

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