Provider Demographics
NPI:1629206313
Name:LEILA JARRAHI, PHD, PC
Entity Type:Organization
Organization Name:LEILA JARRAHI, PHD, PC
Other - Org Name:CHEVY CHASE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRAHI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-654-1203
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 802
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-654-1203
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 802
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-654-1203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04477251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health