Provider Demographics
NPI:1588278311
Name:FEKADE, ABEBA
Entity type:Individual
Prefix:DR
First Name:ABEBA
Middle Name:
Last Name:FEKADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 EISENHOWER AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4587
Mailing Address - Country:US
Mailing Address - Phone:301-395-9142
Mailing Address - Fax:703-683-5480
Practice Address - Street 1:2800 EISENHOWER AVE STE 210
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4587
Practice Address - Country:US
Practice Address - Phone:301-395-9142
Practice Address - Fax:703-683-5480
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)