NPIMap

Organization Active NPI

Adaptive Therapy, Inc.

  • Clinical Social Worker
  • La Plata, MD
National Provider Identifier
1013375757
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15217 Issued in MD
Legal business name
ADAPTIVE THERAPY, INC.
Practice address
109 La Grange Ave
Suite 102
La Plata, MD 20646-9592
Phone
(240) 253-7051
Fax
(301) 934-2640
NPI assigned
Feb 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Olimpia F Etts, LCSW
Title
Partner
Phone
(917) 576-7237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 15217 MD Primary

Addresses

Primary practice location

109 La Grange Ave
Suite 102
La Plata, MD 20646-9592

Mailing address

6015 New Forest CT
Apt 5
Waldorf, MD 20603-4735
Phone (240) 607-9207

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1013375757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 NEW FOREST CT",
            "address_2": "APT 5",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034735",
            "telephone_number": "240-607-9207",
            "fax_number": "301-934-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LA GRANGE AVE",
            "address_2": "SUITE 102",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469592",
            "telephone_number": "240-253-7051",
            "fax_number": "301-934-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAPTIVE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "ETTS",
        "authorized_official_first_name": "OLIMPIA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "917-576-7237",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.