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Individual

MRS. CARISSA HANNUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LCPC, LPC

Contact information

Practice address
1350 CONNECTICUT AVE NW STE 203, WASHINGTON, DC 20036-1762
(202) 677-5049
Mailing address
1350 CONNECTICUT AVE NW STE 203, WASHINGTON, DC 20036-1762
(202) 677-5049

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC9923
MD
101YM0800X
Mental Health Counselor
Primary
PRC15264
DC

Other

Enumeration date
06/12/2017
Last updated
12/18/2019
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