NPIMap

Organization Active NPI

Kingsbury Wellness and Learning Group

  • Psychologist
  • Silver Spring, MD
National Provider Identifier
1154983401
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
KINGSBURY WELLNESS AND LEARNING GROUP
Practice address
8720 Georgia Ave Ste 700
Silver Spring, MD 20910-3602
Phone
(202) 545-2410
NPI assigned
Jul 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Dr. Elliott Langlois Conklin, PSY.D.NPI 1255675948
Title
Executive Director
Phone
(202) 545-2410

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

8720 Georgia Ave Ste 700
Silver Spring, MD 20910-3602

Mailing address

8720 Georgia Ave Ste 700
Silver Spring, MD 20910-3602
Phone (202) 545-2410

National Provider Directory

National Provider Directory

Locations

8720 Georgia Ave
Ste 700
Silver Spring, MD 20910
Phone (202) 545-2410

Practitioners & affiliated clinicians

Practitioners 2

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": "1562457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1154983401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 GEORGIA AVE STE 700",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103602",
            "telephone_number": "202-545-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 GEORGIA AVE STE 700",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103602",
            "telephone_number": "202-545-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSBURY WELLNESS AND LEARNING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-07",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_middle_name": "LANGLOIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "202-545-2410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.