Provider Demographics
NPI:1164780094
Name:WELLS-WILBON, RHONDA (LICSW)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:
Last Name:WELLS-WILBON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 417
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-6042
Mailing Address - Country:US
Mailing Address - Phone:301-254-3656
Mailing Address - Fax:
Practice Address - Street 1:4545 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 417
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-6042
Practice Address - Country:US
Practice Address - Phone:301-254-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2012-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical