Active NPI
Jina Elaine Proctor, LICSW
- School Social Worker
- Washington, DC
National Provider Identifier
1316374333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- LC303511
- Practice address
- 601 Mississippi Ave SE
Washington, DC 20032-3862 - Phone
- (202) 671-6426
- NPI assigned
- Oct 4, 2013
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | LC303511 | DC | Primary |
Addresses
Primary practice location
601 Mississippi Ave SE
Washington, DC 20032-3862
Mailing address
4578 Scottsdale PL
Waldorf, MD 20602-4171
Phone (301) 404-9877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC303511 | DC | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1316374333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4578 SCOTTSDALE PL",
"city": "WALDORF",
"state": "MD",
"postal_code": "206024171",
"telephone_number": "301-404-9877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 MISSISSIPPI AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200323862",
"telephone_number": "202-671-6426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "JINA",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "DC",
"license": "LC303511",
"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 Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.