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NPI Code Detail

MEDICARE: AWARENESS TRANSFORMATION EMPOWERMENT CONNECT, LLC

MEDICARE: AWARENESS TRANSFORMATION EMPOWERMENT CONNECT, LLC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1649905043
Entity Type Code : Organization
Provider Name (Legal Business Name) : AWARENESS TRANSFORMATION EMPOWERMENT CONNECT, LLC
Provider Business Mailing Address
First Line : 2776 S ARLINGTON MILL DR # 105
Second Line :
City : ARLINGTON
State : VA
Zip : 22206-3402
Country : US
Telephone Number : 190-926-9629
Fax Number :
Provider Business Practice Location Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number : 909-269-6291
Fax Number :
Authorized Official
Title or Position : LICENSED CLINICAL SOCIAL WORKER
Name : DELRIO MCGEE
Credential : LCSW
Telephone Number : 909-269-6291
Provider Enumeration Date : 07/19/2022
Last Update Date : 07/19/2022

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