Provider Demographics
NPI:1932769866
Name:JEAN, PHALANDE (MFT, LGPC)
Entity Type:Individual
Prefix:
First Name:PHALANDE
Middle Name:
Last Name:JEAN
Suffix:
Gender:F
Credentials:MFT, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 SEMINARY RD APT 2406S
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2922
Mailing Address - Country:US
Mailing Address - Phone:954-857-5908
Mailing Address - Fax:
Practice Address - Street 1:1818 N ST NW STE 315
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2594
Practice Address - Country:US
Practice Address - Phone:202-893-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALGPC00577101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health