Creative Change Dynamic Therapy LLC
Organization Active NPI Community/Behavioral Health Agency · Washington, DC
NPI 1245020833 · NPPES record last updated May 8, 2025
Key facts
- NPI
- 1245020833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- CREATIVE CHANGE DYNAMIC THERAPY LLC
- Practice address
- 2825 Robinson Place, SE # 102
Washington, DC 20020 - Phone
- (240) 528-3406
- NPI assigned
- May 8, 2025
- Organization subpart
- No
Authorized official
- Name
- Dr. Domonique Malloy, PSY.D
- Title
- Owner
- Phone
- (240) 528-3406
Practitioners 1
-
Domonique Malloy, LCPC
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
2825 Robinson Place, SE # 102
Washington, DC 20020
Mailing address
PO Box 2003
Greenbelt, MD 20768-2003
Other providers in Washington, DC
- Kevin M Creamer
- Anita Marie Creasi
- Kerry Rae Creasy
- Creating Connections Closing Circles
- Creative Alternatives Psychotherapy, PLLC
- Creative Health Care Management, LLC
- Creative Minds International Public Charter School
- Creative Pathways, Inc
- Creative Smile Institute LLC
- Creative Therapy, PLLC
All providers in Washington, DC · Community/Behavioral Health Agency in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.