Organization Active NPI

Reignite Psychological & Consulting Services, LLC

  • Counseling Psychologist
  • Washington, DC
National Provider Identifier
1043756224
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY1001159 Issued in DC
Legal business name
REIGNITE PSYCHOLOGICAL & CONSULTING SERVICES, LLC
Practice address
2001 Benning Rd NE
FL 2
Washington, DC 20002-4728
Phone
(202) 595-9003
Fax
(202) 595-9009
NPI assigned
Jan 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Ms. Laytrayal Simmons, PH.D.NPI 1639415219
Title
Psychologist
Phone
(202) 595-9003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X PSY1001159 DC Primary

Addresses

Primary practice location

2001 Benning Rd NE
FL 2
Washington, DC 20002-4728

Mailing address

2001 Benning Rd NE
FL 2
Washington, DC 20002-4728
Phone (202) 595-9003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170202000166 DC Part B Supplier - Clinic/Group Practice 9739462581 Receives reassigned benefits from 3 practitioners
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

2 Florida Ave NE
Washington, DC 20002

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1043756224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BENNING RD NE",
            "address_2": "FL 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024728",
            "telephone_number": "202-595-9003",
            "fax_number": "202-595-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BENNING RD NE",
            "address_2": "FL 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024728",
            "telephone_number": "202-595-9003",
            "fax_number": "202-595-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIGNITE PSYCHOLOGICAL & CONSULTING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "LAYTRAYAL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "202-595-9003",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "DC",
            "license": "PSY1001159",
            "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 Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.