Provider Demographics
NPI:1508133414
Name:HONNOLD, EDWARD ERNEST (LICSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ERNEST
Last Name:HONNOLD
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 L ST NW
Mailing Address - Street 2:SUITE 503
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5603
Mailing Address - Country:US
Mailing Address - Phone:202-302-9999
Mailing Address - Fax:202-728-0560
Practice Address - Street 1:1660 L ST NW
Practice Address - Street 2:SUITE 503
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5603
Practice Address - Country:US
Practice Address - Phone:202-302-9999
Practice Address - Fax:202-728-0560
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3025351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical