Provider Demographics
NPI:1124286273
Name:AEGIS HEALTH PROFESSIONALS
Entity type:Organization
Organization Name:AEGIS HEALTH PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MELINDA
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:202-361-4962
Mailing Address - Street 1:11 DUPONT CIR NW
Mailing Address - Street 2:SUITE 750
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1207
Mailing Address - Country:US
Mailing Address - Phone:202-361-3962
Mailing Address - Fax:202-478-0376
Practice Address - Street 1:11 DUPONT CIR NW
Practice Address - Street 2:SUITE 750
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1207
Practice Address - Country:US
Practice Address - Phone:202-361-3962
Practice Address - Fax:202-478-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty