Provider Demographics
NPI:1265589410
Name:AMEEN, EDWARD JOHN (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOHN
Last Name:AMEEN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:EDDY
Other - Middle Name:
Other - Last Name:AMEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 75983
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013-0983
Mailing Address - Country:US
Mailing Address - Phone:202-630-3339
Mailing Address - Fax:
Practice Address - Street 1:2 MASSACHUSETTS AVE NE UNIT 75983
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20013-5620
Practice Address - Country:US
Practice Address - Phone:202-630-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health