MEDICARE: JAHNIEKA CHARNAE GRIFFIN R-DMT

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1538852652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAHNIEKA CHARNAE GRIFFIN R-DMT

Provider Business Mailing Address
First Line	:	5768 VIRGINIA LN
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-3574
Country	:	US
Telephone Number	:	202-716-1913
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 PENNSYLVANIA AVE SE STE 415
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-4303
Country	:	US
Telephone Number	:	888-878-8236
Fax Number	:

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

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	02/03/2026

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