Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Tisdale

Individual provider Counselor · NPI 1063117976

Kevin Tisdale is a Counselor in Washington, District of Columbia. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
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Practice location Address checks out

4660 Martin Luther King Jr Ave SW
Washington, DC 20032-4933
Phone: (202) 318-0179
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Counselor Taxonomy 101Y00000X

Record details

NPI number1063117976
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 31, 2023
Last updated in NPPESJune 14, 2023
Certification dateJune 14, 2023

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