Provider Demographics
NPI:1609224377
Name:HUMAN REVOLUTIONS, LLC
Entity Type:Organization
Organization Name:HUMAN REVOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:BONITA
Authorized Official - Last Name:BOYKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:202-744-1393
Mailing Address - Street 1:1629 K ST NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1602
Mailing Address - Country:US
Mailing Address - Phone:202-744-1393
Mailing Address - Fax:
Practice Address - Street 1:1321 BUCHANAN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4446
Practice Address - Country:US
Practice Address - Phone:202-744-1393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC400314001529251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health