# FORTITUDE WELLNESS COLLECTIVE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063118776
- **Authorized official:** RASHONDA IESHA RILEY LCSW, LICSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (228) 218-3593

## Contact information

- **Practice address:** 3922 VERMONT AVE, ALEXANDRIA, VA 22304-6325
- **Practice address phone:** (202) 505-1916
- **Mailing address:** 712 H ST NE STE 1851, WASHINGTON, DC 20002-3627
- **Mailing address phone:** (202) 505-1916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2023
- **Last updated:** 02/05/2023