| Inner City Family Services Llc | |
|
2307 Martin Luther King Jr Avenue Southeast Washington DC 20020 | |
| (202) 525-4855 | |
| Not Available |
| Full Name | Inner City Family Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2307 Martin Luther King Jr Avenue Southeast, Washington, District Of Columbia |
| Authorized Official Name and Position | Rachael Shpak (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2025254855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner City Family Services Llc 2307 Martin Luther King Jr Ave Se Washington DC 20020-5813 Ph: (202) 525-4855 | Inner City Family Services Llc 2307 Martin Luther King Jr Avenue Southeast Washington DC 20020 Ph: (202) 525-4855 |
| NPI Number | 1447556600 |
|---|---|
| Provider Enumeration Date | 02/07/2011 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Medicare PECOS PAC ID | 0143460519 |
|---|---|
| Medicare Enrollment ID | O20130708000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447556600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tonya Walston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265894745 PECOS PAC ID: 7214211051 Enrollment ID: I20170223000340 |
| Provider Name | Rochelle Spiker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407026586 PECOS PAC ID: 1153677125 Enrollment ID: I20180705000486 |
| Provider Name | Jean Marc Nken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972072775 PECOS PAC ID: 5597005355 Enrollment ID: I20190314001639 |
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