Provider Demographics
NPI:1376850511
Name:DEPP, GRACE HANNAH (LICSW, MDIV)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:HANNAH
Last Name:DEPP
Suffix:
Gender:F
Credentials:LICSW, MDIV
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:HANNAH
Other - Last Name:TIVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1612 K ST. NW
Mailing Address - Street 2:SUITE 706
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:301-805-6781
Mailing Address - Fax:
Practice Address - Street 1:1612 K ST. NW
Practice Address - Street 2:SUITE 706
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:301-805-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC003024101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical