Provider Demographics
NPI:1063646347
Name:ANACOSTIA CENTER FOR PSYCHOTHERAPY & COUNSELING, INC.
Entity Type:Organization
Organization Name:ANACOSTIA CENTER FOR PSYCHOTHERAPY & COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:LSW,LPC
Authorized Official - Phone:202-561-1423
Mailing Address - Street 1:2025 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7023
Mailing Address - Country:US
Mailing Address - Phone:202-561-1423
Mailing Address - Fax:202-561-1481
Practice Address - Street 1:2025 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7023
Practice Address - Country:US
Practice Address - Phone:202-561-1423
Practice Address - Fax:202-561-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC 416251S00000X
IN33003023A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health