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Organization

SHONA WELLNESS GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA C CAMPBELL LICSW (SOCIAL WORKER)
(202) 431-1682
Entity
Organization

Contact information

Practice address
1030 KEARNY ST NE, WASHINGTON, DC 20017-3518
(202) 431-1682
Mailing address
6621 HIGHGATE DR, FORT WASHINGTON, MD 20744-1002
(202) 431-1682

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
200-1064
DC
101YP2500X
Professional Counselor
PRC293
DC
1041C0700X
Clinical Social Worker
Primary
LC50080073
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326468950
DC
05
1326475492
DC
Enumeration date
04/07/2016
Last updated
10/18/2016
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