Provider Demographics
NPI:1518016070
Name:COMPREHENSIVE ADDICTION & PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE ADDICTION & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:202-607-1613
Mailing Address - Street 1:313 ONEIDA ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1617
Mailing Address - Country:US
Mailing Address - Phone:202-607-1613
Mailing Address - Fax:
Practice Address - Street 1:313 ONEIDA ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1617
Practice Address - Country:US
Practice Address - Phone:202-607-1613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC273101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC10744608OtherCAGH ID#