Active NPI
Perry Vaughn King, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1013036649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC302242
- Practice address
- 3020 14TH St NW
Suite 402B
Washington, DC 20009-6865 - Phone
- (202) 745-4300
- Fax
- (202) 232-0723
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC302242 | DC | Primary |
Addresses
Primary practice location
3020 14TH St NW
Suite 402B
Washington, DC 20009-6865
Mailing address
3020 14TH St NW
Suite 402B
Washington, DC 20009-6865
Phone (202) 745-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC302242 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013036649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 14TH ST NW",
"address_2": "SUITE 402B",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200096865",
"telephone_number": "202-745-4300",
"fax_number": "202-232-0723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 14TH ST NW",
"address_2": "SUITE 402B",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200096865",
"telephone_number": "202-745-4300",
"fax_number": "202-232-0723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "PERRY",
"middle_name": "VAUGHN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC302242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.