Individual provider Active NPI

Tywanda McLaurin-Jones, PH.D.

  • Clinical Psychologist
  • Waldorf, MD
National Provider Identifier
1316484488
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05701 Issued in MD
Practice address
3200 Crain Hwy
Suite 203
Waldorf, MD 20603-4841
Phone
(301) 860-7755
NPI assigned
Jan 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05701 MD Primary

Addresses

Primary practice location

3200 Crain Hwy
Suite 203
Waldorf, MD 20603-4841

Mailing address

3200 Crain Hwy
Suite 203
Waldorf, MD 20603-4841
Phone (301) 860-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322002003 DC Practitioner - Clinical Psychologist 6901291301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Howard University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard UniversityGroup PAC ID 0941109565, 182 clinicians

Practice addresses (Care Compare)

2139 Georgia Ave NW
Washington, DC 20001-3035
Phone (202) 865-6679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05701MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard University CurrentSince Dec 20, 2021 Accepting new patients

Locations

2139 Georgia Ave NW
Washington, DC 20001
Phone (202) 865-1121

2041 Georgia Ave NW
Ste 3400
Washington, DC 20060
Phone (202) 865-6679

2101 Medical Park Dr
Ste 305
Silver Spring, MD 20902
Phone (301) 754-0833

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1316484488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY",
            "address_2": "SUITE 203",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034841",
            "telephone_number": "301-860-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY",
            "address_2": "SUITE 203",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034841",
            "telephone_number": "301-860-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN-JONES",
        "first_name": "TYWANDA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.