Provider Demographics
NPI:1992488258
Name:PILLAY, KRISTIN AMY SWENSON (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:AMY SWENSON
Last Name:PILLAY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:AMY
Other - Last Name:SWENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5506 CONNECTICUT AVE NW STE 25
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2600
Mailing Address - Country:US
Mailing Address - Phone:202-455-0706
Mailing Address - Fax:
Practice Address - Street 1:5506 CONNECTICUT AVE NW STE 25
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2600
Practice Address - Country:US
Practice Address - Phone:202-455-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500798951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty