Provider Demographics
NPI:1194602359
Name:CARDINAL HOPE AND HEALING LLC
Entity type:Organization
Organization Name:CARDINAL HOPE AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICWS, LCSW
Authorized Official - Phone:202-381-3997
Mailing Address - Street 1:1763 COLUMBIA RD NW STE 175
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2891
Mailing Address - Country:US
Mailing Address - Phone:202-381-3997
Mailing Address - Fax:202-318-0501
Practice Address - Street 1:1763 COLUMBIA RD NW STE 175
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2891
Practice Address - Country:US
Practice Address - Phone:202-318-3997
Practice Address - Fax:202-318-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty