Provider Demographics
NPI:1184382855
Name:LOPEZ FARIA, LETICIA DE CASSIA (LPC)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:DE CASSIA
Last Name:LOPEZ FARIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 WISCONSIN AVE NW STE 260
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4118
Mailing Address - Country:US
Mailing Address - Phone:202-361-5498
Mailing Address - Fax:
Practice Address - Street 1:2020 PENNSYLVANIA AVE NW STE 272
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1811
Practice Address - Country:US
Practice Address - Phone:202-759-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC919101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor