Organization
PROGRESSIVE LIFE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK BRIAN PHILLIPS PSY.D. (PRESIDENT)
(202) 349-7663
Entity
Organization
Contact information
Practice address
1933 MONTANA AVE NE, WASHINGTON, DC 20002-1817
(202) 349-7663
(202) 842-0604
Mailing address
1933 MONTANA AVE NE, WASHINGTON, DC 20002-1817
(202) 349-7663
(202) 842-0604
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 1060
DC
1041C0700X
Clinical Social Worker
LC301232
DC
Other
Enumeration date
02/09/2016
Last updated
04/12/2016
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