Provider Demographics
NPI:1174343487
Name:GARRATT, JESSICA BROOKE (MA, LGPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:BROOKE
Last Name:GARRATT
Suffix:
Gender:F
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW STE 1103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1729
Mailing Address - Country:US
Mailing Address - Phone:202-930-1907
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 1103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1729
Practice Address - Country:US
Practice Address - Phone:202-930-1907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15761101Y00000X
DCLGPC200001744101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor