Provider Demographics
NPI:1659611457
Name:FOBANJONG, ABIGAIL CHRISTINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:CHRISTINE
Last Name:FOBANJONG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:CHRISTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1313 NEW YORK AVE. NW
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4701
Mailing Address - Country:US
Mailing Address - Phone:202-737-6191
Mailing Address - Fax:
Practice Address - Street 1:1313 NEW YORK AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4701
Practice Address - Country:US
Practice Address - Phone:202-737-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14336101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional