DC Psychotherapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50079008 Issued in DC

Legal business name

DC PSYCHOTHERAPY PLLC

Practice address

5247 Wisconsin Ave NW
Suite 2
Washington, DC 20015-2012

Phone

(202) 271-5673

NPI assigned

Jun 7, 2012

Organization subpart

No

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

Authorized official

Name

Cornelia Tietke, MSWNPI 1902196306

Title

Sole Member

Phone

(202) 271-5673

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cornelia Tietke, LICSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1902196306
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1285996033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 WISCONSIN AVE NW",
            "address_2": "SUITE 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152012",
            "telephone_number": "202-271-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 WISCONSIN AVE NW",
            "address_2": "SUITE 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152012",
            "telephone_number": "202-271-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "TIETKE",
        "authorized_official_first_name": "CORNELIA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "202-271-5673",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DC Pain and Rehab
• DC Pain Center Inc
• DC Perio& Implants
• DC Plastic Surgery Boutique LLC
• DC Prepatory Academy Public Charter School
• DC Public Schools
• DC Public Schools
• DC Public Schools
• DC Recovery Counseling LLC
• DC Residential Services Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.