Provider Demographics
NPI:1265236988
Name:ODOM, ARIARNA M (LGPC)
Entity type:Individual
Prefix:
First Name:ARIARNA
Middle Name:M
Last Name:ODOM
Suffix:
Gender:
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BUCHANAN ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6718
Mailing Address - Country:US
Mailing Address - Phone:202-306-3014
Mailing Address - Fax:410-834-1217
Practice Address - Street 1:1036 SAINT NICHOLAS DR UNIT 102
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4758
Practice Address - Country:US
Practice Address - Phone:410-934-0580
Practice Address - Fax:410-834-1217
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC20001871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional