Organization
REQUEST THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY IBIKUNLE MD (CEO)
(202) 765-3131
Entity
Organization
Contact information
Practice address
16623 HEARTWOOD DR, ROCKVILLE, MD 20855-1625
(202) 765-3131
Mailing address
16623 HEARTWOOD DR, ROCKVILLE, MD 20855-1625
(202) 765-3131
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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