Provider Demographics
NPI:1396986899
Name:DRODDY, JACQUELINE LYNN (LICSW)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:LYNN
Last Name:DRODDY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 NEW YORK AVE NE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3320
Mailing Address - Country:US
Mailing Address - Phone:202-222-8785
Mailing Address - Fax:202-673-7502
Practice Address - Street 1:64 NEW YORK AVE NE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3320
Practice Address - Country:US
Practice Address - Phone:202-222-8785
Practice Address - Fax:202-673-7502
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500779231041C0700X
MD106211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical