The Mecca Group

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Legal business name

THE MECCA GROUP

Practice address

1050 17TH St NW
Suite 800
Washington, DC 20036-5503

Phone

(202) 529-3117

Fax

(202) 529-3117

NPI assigned

Mar 26, 2007

Last updated

Feb 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keisha L Mack, PHD

Title

Licensed Clinical Psyhologist

Phone

(202) 529-3117

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1265550578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 17TH ST NW",
            "address_2": "SUITE 800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365503",
            "telephone_number": "202-529-3117",
            "fax_number": "202-529-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 17TH ST NW",
            "address_2": "SUITE 800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365503",
            "telephone_number": "202-529-3117",
            "fax_number": "202-529-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MECCA GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYHOLOGIST",
        "authorized_official_telephone_number": "202-529-3117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Washington, DC
• Providers in Washington, DC by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.