Provider Demographics
NPI:1124515002
Name:COUDENHOVE-KALERGI, SOPHIA (LCSW-C)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:COUDENHOVE-KALERGI
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:COUDENHOVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3830 FULTON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1344
Mailing Address - Country:US
Mailing Address - Phone:202-821-5562
Mailing Address - Fax:
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:202-821-5562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MD163981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty