Provider Demographics
NPI:1992919492
Name:RIS, ADRIENNE WOLF (LICSW)
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:WOLF
Last Name:RIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015
Mailing Address - Country:US
Mailing Address - Phone:202-363-6808
Mailing Address - Fax:301-657-4208
Practice Address - Street 1:5410 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 106
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015
Practice Address - Country:US
Practice Address - Phone:202-363-6808
Practice Address - Fax:301-657-4208
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC300789LICSW1041C0700X
MD912LCSWC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical