MISS SHIVONNE A ODOM LCPC
NPI 1013206135
Counselor - Professional in Washington, DC
Active since March 29, 2011
About Miss Shivonne A Odom Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISS SHIVONNE A ODOM LCPC (NPI 1013206135) is an individual professional provider in Washington, District Of Columbia, licensed in Maryland (LC3868) and active in the NPI registry since March 2011.
NPPES Registry Identity
NPI1013206135
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMISS SHIVONNE A ODOMCredential: LCPC
Location Address306 ATLANTIC ST SE, #3Washington, DC 20032-3098
Mailing Address306 Atlantic St Se, #3Washington, DC 20032-3098 · (508) 272-6348
Phone(508) 272-6348
Sole ProprietorNo
Enumeration DateMarch 29, 2011
Last NPPES UpdateNovember 3, 2016
✔ NPI 1013206135 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MD · LC3868
Also ListedCounselorTaxonomy 101Y00000X · License PRC14590 (DC)
306 ATLANTIC ST SE, Washington, DC 20032
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013206135, enumerated as an "individual" on March 29, 2011.
The provider is located at 306 ATLANTIC ST SE #3 WASHINGTON, DC 20032 and the phone number is (508) 272-6348.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
