Provider Demographics
NPI:1689067423
Name:YOUR NEIGHBORHOOD CLINIC
Entity Type:Organization
Organization Name:YOUR NEIGHBORHOOD CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAREEFAH
Authorized Official - Middle Name:N
Authorized Official - Last Name:AL'UQDAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-213-2637
Mailing Address - Street 1:2007 VERMONT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4029
Mailing Address - Country:US
Mailing Address - Phone:202-643-8012
Mailing Address - Fax:
Practice Address - Street 1:2007 VERMONT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4029
Practice Address - Country:US
Practice Address - Phone:202-643-8012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY100748103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty