Individual provider Active NPI

Shereece Xuxa Fraites

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1073158077
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200002242 Issued in DC
Practice address
2333 Ontario Rd NW
Washington, DC 20009-2627
Phone
(202) 483-8196
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC200002242 DC Primary
Social Worker 104100000X LG50083149 DC

Addresses

Primary practice location

2333 Ontario Rd NW
Washington, DC 20009-2627

Mailing address

1411 Jefferson St
Hyattsville, MD 20782-3451
Phone (340) 513-7560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LG50083149DCMDSocial Worker
LC200002242DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1073158077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 JEFFERSON ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823451",
            "telephone_number": "340-513-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-483-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAITES",
        "first_name": "SHEREECE",
        "middle_name": "XUXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200002242",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG50083149",
            "primary": false
        }
    ],
    "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 12, 2023; 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.