Provider Demographics
NPI:1679290183
Name:HONG, ELLAINNA I (LICSW, LCSW)
Entity type:Individual
Prefix:
First Name:ELLAINNA
Middle Name:I
Last Name:HONG
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7473 DIGBY GRN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5220
Mailing Address - Country:US
Mailing Address - Phone:202-489-2557
Mailing Address - Fax:
Practice Address - Street 1:333 HAWAII AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4966
Practice Address - Country:US
Practice Address - Phone:202-232-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500805221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical