Provider Demographics
NPI:1215385513
Name:OJO, CARRIE MACMILLIN (LICSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:MACMILLIN
Last Name:OJO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:MACMILLIN
Other - Last Name:SHEPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:60 O ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1259
Mailing Address - Country:US
Mailing Address - Phone:202-797-8806
Mailing Address - Fax:
Practice Address - Street 1:4 ATLANTIC ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2350
Practice Address - Country:US
Practice Address - Phone:202-540-9857
Practice Address - Fax:202-232-8494
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500808631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical