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Individual
TABE NKI
Active
Individual
TABE NKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CACII200001243
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CACII200001243
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/14/2021
Last updated
07/11/2024
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