Provider Demographics
NPI:1346737079
Name:EHC THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:EHC THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ELIA
Authorized Official - Middle Name:HEIDIANN
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:202-618-0754
Mailing Address - Street 1:701 BRANDYWINE ST SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3551
Mailing Address - Country:US
Mailing Address - Phone:202-629-3026
Mailing Address - Fax:
Practice Address - Street 1:113 S WEST ST STE 204
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2851
Practice Address - Country:US
Practice Address - Phone:202-618-0754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty