Elliott Langlois Conklin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1001012 Issued in DC

Practice address

5000 14TH St NW
Washington, DC 20011-6926

Phone

(703) 982-0211

NPI assigned

Nov 19, 2012

Last updated

Sep 6, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kingsbury Wellness and Learning Group

  • Psychologist
  • Silver Spring, MD
  • NPI 1154983401
  NPD Authorized official

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1255675948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 14TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200116926",
            "telephone_number": "703-982-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 14TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200116926",
            "telephone_number": "703-982-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "ELLIOTT",
        "middle_name": "LANGLOIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810-004805",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1001012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Alexander Condrell, M.D.
• Michael Condrey, RN
• Stephanie Cone, MOT, OTR/L
• Confident Care Medical LLC
• Claire Katherine Conklin, APRN
• Laurie Susan Conklin, M.D.
• Philip Michael Conklin, MSW, LICSW
• Rose Ella Conklin, APRN, FNP-C
• Suzanne Adelman Conkling, LICSW
• Caroline Conley, LICSW

• Clinical Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.