Provider Demographics
NPI:1558831982
Name:GARCIA-DITTA, ANGELICA (LICSW)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:GARCIA-DITTA
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 1:2223 ONTARIO RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2606
Mailing Address - Country:US
Mailing Address - Phone:202-430-7455
Mailing Address - Fax:
Practice Address - Street 1:2 M ST NE APT 1213
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3993
Practice Address - Country:US
Practice Address - Phone:713-857-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500819741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical