MEDICARE: BRIANA LEVERETTE

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	101Y00000X	Counselor	PRC200001557	DC
2	101YP2500X	Professional Counselor	PRC200001557	DC

General Provider Information

NPI Number	:	1326776204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA LEVERETTE

Provider Business Mailing Address
First Line	:	801 49TH ST NE APT 101
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4876
Country	:	US
Telephone Number	:	202-509-2477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 P ST NW STE 200
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-6924
Country	:	US
Telephone Number	:	443-415-2328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	08/14/2024

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Directions to “ BRIANA LEVERETTE ” Practice Location

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