Organization
COVENANT HOUSE DC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARRETT MUSHAW (DIRECTOR OF FINANCE)
(202) 610-9603
Entity
Organization
Contact information
Practice address
2001 MISSISSIPPI AVE, SE, WASHINGTON, DC 20020
(202) 610-9603
Mailing address
2001 MISSISSIPPI AVE SE, WASHINGTON, DC 20020-6116
(202) 610-9603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
DC
101YP2500X
Professional Counselor
—
DC
102L00000X
Psychoanalyst
—
DC
103T00000X
Psychologist
—
DC
103TC1900X
Counseling Psychologist
Primary
—
DC
103TC2200X
Clinical Child & Adolescent Psychologist
—
DC
103TF0000X
Family Psychologist
—
DC
103TP2701X
Group Psychotherapy Psychologist
—
DC
104100000X
Social Worker
—
DC
1041C0700X
Clinical Social Worker
—
DC
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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