Provider Demographics
NPI:1063503241
Name:DEGAIFFIER, EDMOND LOUIS (MSW, LICSW, LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:EDMOND
Middle Name:LOUIS
Last Name:DEGAIFFIER
Suffix:
Gender:M
Credentials:MSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E ST SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2620
Mailing Address - Country:US
Mailing Address - Phone:202-297-1700
Mailing Address - Fax:202-543-2232
Practice Address - Street 1:50 E ST SE
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2620
Practice Address - Country:US
Practice Address - Phone:202-297-1700
Practice Address - Fax:202-543-2232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3034811041C0700X
MD111021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical