Adaptive Therapy, Inc.

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

Last updated

Feb 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Olimpia F Etts, LCSWNPI 1710133285

Title

Partner

Phone

(917) 576-7237

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olimpia Fiore Etts, LCSW-C

  • Clinical Social Worker
  • La Plata, MD
  • NPI 1710133285
  Authorized official Same address or phone

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": []
}

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• Clinical Social Worker in La Plata, MD
• Providers in La Plata, MD by specialty
• Clinical Social Worker in Maryland

• 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.