Provider Demographics
NPI:1033762067
Name:YANNI, AMIRA
Entity Type:Individual
Prefix:
First Name:AMIRA
Middle Name:
Last Name:YANNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 G ST NW STE 800
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON DC
Mailing Address - State:DC
Mailing Address - Zip Code:20005
Mailing Address - Country:US
Mailing Address - Phone:240-912-2220
Mailing Address - Fax:301-926-9384
Practice Address - Street 1:1901 N. FORT MYER DRIVE, STE 1130
Practice Address - Street 2:ROCK RECOVERY
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209
Practice Address - Country:US
Practice Address - Phone:571-255-9906
Practice Address - Fax:301-926-9384
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2021-11-19
Deactivation Date:2021-09-23
Deactivation Code:
Reactivation Date:2021-10-15
Provider Licenses
StateLicense IDTaxonomies
VA0704014430101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor