Kisha Jowanda Coley, CACII
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Washington, DC
NPI 1619675584 · NPPES record last updated Feb 21, 2023
Key facts
- NPI
- 1619675584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CACII1412 (DC)
- Practice address
- 2112 F St NW Ste 102
Washington, DC 20037-2722 - Phone
- (202) 296-4455
- NPI assigned
- Feb 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CACII1412 | DC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baymark Health Services of West Virginia, Inc. | Current |
Accepting new patients | |
| Baymark Health Services of West Virginia, Inc. | Past | Accepting new patients |
Locations
2112 F St NW
Ste 102
Washington, DC 20037
Phone (202) 292-4455
2112 F St NW
Ste 101
Washington, DC 20037
Phone (202) 296-4455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CACII1412 | DC | Yes |
Addresses
Primary practice location
2112 F St NW Ste 102
Washington, DC 20037-2722
Mailing address
2725 Terrace Rd SE # 351
Washington, DC 20020-2541
Phone (202) 864-9403
Other providers in Washington, DC
- Ashley Coley
- Desiree Coley
- James Frederick Coley Jr.
- John Edward Coley Jr.
- Jordan Coley
- Nicholas Bruce Coley
- Sandra M. Coley
- Wongduen Coley
- James Douglas Colgain
- Gene L. Colice
All providers in Washington, DC · Addiction (Substance Use Disorder) Counselor 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 Feb 21, 2023. 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.