Active NPI
Mia Phaire, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1154172922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC200002825
- Practice address
- 110 Irving St NW
Washington, DC 20010-3017 - Phone
- (202) 877-7000
- NPI assigned
- Mar 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC200002825 | DC | Primary |
Addresses
Primary practice location
110 Irving St NW
Washington, DC 20010-3017
Mailing address
1011 Montgomery St
Laurel, MD 20707-3413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC200002825 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720310400000",
"number": "1154172922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 MONTGOMERY ST",
"city": "LAUREL",
"state": "MD",
"postal_code": "207073413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 IRVING ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200103017",
"telephone_number": "202-877-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAIRE",
"first_name": "MIA",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-29",
"last_updated": "2024-07-07",
"certification_date": "2024-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC200002825",
"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 Jul 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.