Provider Demographics
NPI:1295237634
Name:WITHOUT WALLS COUNSELING CENTER
Entity type:Organization
Organization Name:WITHOUT WALLS COUNSELING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANTAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITE-ELEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, CEAP,BCD
Authorized Official - Phone:253-576-8514
Mailing Address - Street 1:316 LISMORE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6512
Mailing Address - Country:US
Mailing Address - Phone:202-657-1500
Mailing Address - Fax:240-846-5999
Practice Address - Street 1:2121 EISENHOWER AVE STE 301
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4688
Practice Address - Country:US
Practice Address - Phone:202-657-1500
Practice Address - Fax:240-846-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty