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Contact Information

KEISHA L MACK, PhD
3800 RESERVOIR RD NW
WASHINGTON, DC20007-2113
 Phone: 202-444-5437
 Fax: 202-444-2931
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KEISHA L MACK · (Female)

NPI Number 1104074970
Status Active
Credentials PhD
Entity Individual
Enumeration date 09/04/2008
Last updated 03/09/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • DC License # PSY1000323
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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