Provider Demographics
NPI:1821151242
Name:HUCK, NATHAN (PHD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:HUCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MASSACHUSETTS AVE NW
Mailing Address - Street 2:APT 353
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-1821
Mailing Address - Country:US
Mailing Address - Phone:202-782-5904
Mailing Address - Fax:202-782-7165
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:BUILDING 6, 3RD FLOOR, DEPARTMENT OF PSYCHOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0003
Practice Address - Country:US
Practice Address - Phone:202-782-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical