Active NPI
Carrelle Shaffer Tiller, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1346361029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC50077825
- Practice address
- 1630 Connecticut Ave NW
Suite 400
Washington, DC 20009-1053 - Phone
- (240) 463-1834
- NPI assigned
- Apr 2, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC50077825 | DC | Primary |
Addresses
Primary practice location
1630 Connecticut Ave NW
Suite 400
Washington, DC 20009-1053
Mailing address
1621 Montague St NW
Washington, DC 20011-2873
Phone (240) 463-1834
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 |
|---|---|---|---|
| LC50077825 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1346361029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 MONTAGUE ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200112873",
"telephone_number": "240-463-1834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 CONNECTICUT AVE NW",
"address_2": "SUITE 400",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200091053",
"telephone_number": "240-463-1834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLER",
"first_name": "CARRELLE",
"middle_name": "SHAFFER",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC50077825",
"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 Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.