Provider Demographics
NPI:1801151865
Name:JAIN, KSHIPRA
Entity type:Individual
Prefix:
First Name:KSHIPRA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 G ST NW
Mailing Address - Street 2:ROOM 403
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20052-0076
Mailing Address - Country:US
Mailing Address - Phone:202-994-8509
Mailing Address - Fax:
Practice Address - Street 1:2129 G ST NW
Practice Address - Street 2:ROOM 403
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20052-0076
Practice Address - Country:US
Practice Address - Phone:202-994-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health