Provider Demographics
NPI:1508405200
Name:HENRY, MARIA CLOUDS (CERTIFIED PEER)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CLOUDS
Last Name:HENRY
Suffix:
Gender:F
Credentials:CERTIFIED PEER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 I ST SE APT 11
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4103
Mailing Address - Country:US
Mailing Address - Phone:202-249-1000
Mailing Address - Fax:
Practice Address - Street 1:1214 I ST SE APT 11
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4103
Practice Address - Country:US
Practice Address - Phone:202-249-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist