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is a Nurse Practitioner - Psychiatric/mental Health based in Washington, District Of Columbia. is licensed to practice in * (Not Available) (license number ) and their current practice location is 1420 N St Nw Ste 102, Washington, District Of Columbia. It can be reached at their office (for appointments etc.) via phone at (202) 506-0416.

NPI number for is 1659005445 and their current mailing address is 5200 Devonport Ct, Glenn Dale, Maryland. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1659005445.

Contact Information

1420 N St Nw Ste 102,
Washington, DC 20005-2876
(202) 506-0416
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1420 N St Nw Ste 102, Washington, District Of Columbia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1659005445
  • Provider Enumeration Date: 07/15/2022
  • Last Update Date: 07/31/2024

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659005445NPI-NPPES
NAMedicaidDC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist (* (Not Available))Secondary
251B00000XCase Management (* (Not Available))Secondary
251C00000XDay Training, Developmentally Disabled Services (* (Not Available))Secondary
251E00000XHome Health (* (Not Available))Secondary
251G00000XHospice Care, Community Based (* (Not Available))Secondary
261QD1600XClinic/center - Developmental Disabilities (* (Not Available))Secondary
310400000XAssisted Living Facility (* (Not Available))Secondary
3104A0630XAssisted Living Facility - Assisted Living, Behavioral Disturbances (* (Not Available))Secondary
314000000XSkilled Nursing Facility (* (Not Available))Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health (* (Not Available))Primary
372500000XChore Provider (* (Not Available))Secondary
385H00000XRespite Care (* (Not Available))Secondary
385HR2050XRespite Care - Respite Care Camp (* (Not Available))Secondary
385HR2060XRespite Care - Respite Care, Intellectual And/or Developmental Disabilities, Child (* (Not Available))Secondary
385HR2065XRespite Care - Respite Care, Physical Disabilities, Child (* (Not Available))Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

5200 Devonport Ct,
Glenn Dale, MD 20769-9141

Ph: (202) 506-0416
1420 N St Nw Ste 102,
Washington, DC 20005-2876

Ph: (202) 506-0416

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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