Provider Demographics
NPI:1891333647
Name:ISBY, LATISSHA (LICSW)
Entity Type:Individual
Prefix:
First Name:LATISSHA
Middle Name:
Last Name:ISBY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 52ND ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5546
Mailing Address - Country:US
Mailing Address - Phone:301-804-7698
Mailing Address - Fax:
Practice Address - Street 1:909 52ND ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5546
Practice Address - Country:US
Practice Address - Phone:301-804-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical