# IMAGO CENTER WASHINGTON DC

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

## Provider details

- **NPI number:** 1508218199
- **Authorized official:** DR. CARL SIEGEL PHD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (202) 669-6417

## Contact information

- **Practice address:** 1920 G ST NW, WASHINGTON, DC 20006-4303
- **Practice address phone:** (434) 466-4004
- **Mailing address:** 7003 PINEY BRANCH RD NW, WASHINGTON, DC 20012-2417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LGP5845 | MD | Yes |

## Other

- **Enumeration date:** 07/07/2016
- **Last updated:** 07/07/2016
