NPIMap

Organization Active NPI

Elevating Minds Wellness Center, LLC

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1053166579
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELEVATING MINDS WELLNESS CENTER, LLC
Practice address
80 M St SE Ste 100
Washington, DC 20003-3550
Phone
(202) 360-2400
NPI assigned
Apr 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Ms. Shavon A Warrick, LICSWNPI 1437214376
Title
Independent Clinical Social Worker
Phone
(202) 360-2400

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

80 M St SE Ste 100
Washington, DC 20003-3550

Mailing address

10204 Eyelet CT
Clinton, MD 20735-5832
Phone (202) 360-2400

National Provider Directory

National Provider Directory

Locations

80 M St SE
Ste 100
Washington, DC 20003
Phone (202) 360-2400

Practitioners & affiliated clinicians

Practitioners 1

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": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1053166579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 EYELET CT",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207355832",
            "telephone_number": "202-360-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 M ST SE STE 100",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033550",
            "telephone_number": "202-360-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATING MINDS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "WARRICK",
        "authorized_official_first_name": "SHAVON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INDEPENDENT CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "202-360-2400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Apr 18, 2024; 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.