MEDICARE: KASVU COUNSELING, PLLC

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	PSY1001024	DC
2	103T00000X	Psychologist	PSY1001024	DC

General Provider Information

NPI Number	:	1457808909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASVU COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	1350 CONNECTICUT AVE NW STE 612
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1735
Country	:	US
Telephone Number	:	202-656-0258
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 CONNECTICUT AVE NW STE 612
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1735
Country	:	US
Telephone Number	:	202-656-0258
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	DAVIN MAIJALA
Credential	:	PSYD
Telephone Number	:	202-656-0258

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	07/21/2022

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