Provider Demographics
NPI:1710740592
Name:BEHNA, ERIC (LGSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BEHNA
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 ECKINGTON PL NE APT 328
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2768
Mailing Address - Country:US
Mailing Address - Phone:630-664-7810
Mailing Address - Fax:
Practice Address - Street 1:2651 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7706
Practice Address - Country:US
Practice Address - Phone:678-209-6961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200001519104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker