Provider Demographics
NPI:1922777044
Name:WOODS, STEPHANIE HEATHER
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:HEATHER
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14608 MAN O WAR DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1295
Mailing Address - Country:US
Mailing Address - Phone:301-502-7381
Mailing Address - Fax:
Practice Address - Street 1:1627 K ST NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1708
Practice Address - Country:US
Practice Address - Phone:202-515-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-11
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27681104100000X
DCLG50083786104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker