Provider Demographics
NPI:1467252726
Name:PHILLIPS, KIANA (LGSW)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CONNECTICUT AVE NW STE 450
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4359
Mailing Address - Country:US
Mailing Address - Phone:202-706-7603
Mailing Address - Fax:
Practice Address - Street 1:1101 CONNECTICUT AVE NW STE 450
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4359
Practice Address - Country:US
Practice Address - Phone:202-706-7603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50082991104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker