# PROACTIVE PSYCHIATRY LC

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

## Provider details

- **NPI number:** 1902656929
- **Authorized official:** RYAN SHERIDAN (PRINCIPAL CLINICIAN & CEO)
- **Authorized official phone:** (202) 640-5502

## Contact information

- **Practice address:** 1718 CONNECTICUT AVE NW STE 201, WASHINGTON, DC 20009-1148
- **Practice address phone:** (202) 640-5502
- **Mailing address:** 1629 K ST NW STE 300, WASHINGTON, DC 20006-1631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/25/2024
- **Last updated:** 03/25/2024