Active NPI
Ricardo Dwayne Lagrange, PH.D.
- Clinical Psychologist
- Washington, DC
National Provider Identifier
1427284975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1000543
- Practice address
- 111 Michigan Ave NW
6TH Floor - Research
Washington, DC 20010-2916 - Phone
- (202) 476-4455
- Fax
- (202) 476-3425
- NPI assigned
- Jun 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1000543 | DC | Primary |
| Clinical Psychologist | 103TC0700X | 04481 | MD |
Addresses
Primary practice location
111 Michigan Ave NW
6TH Floor - Research
Washington, DC 20010-2916
Mailing address
7610 Pennsylvania Ave
#203
Forestville, MD 20747-4701
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036596300 | Medicaid | MD | |
| 417682100 | Medicaid | MD | |
| 417682101 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04481 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Basics Group Practice LLC | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Forestville, MD
- NPI 1235444738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1427284975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7610 PENNSYLVANIA AVE",
"address_2": "#203",
"city": "FORESTVILLE",
"state": "MD",
"postal_code": "207474701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"address_2": "6TH FLOOR - RESEARCH",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-4455",
"fax_number": "202-476-3425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGRANGE",
"first_name": "RICARDO",
"middle_name": "DWAYNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-10",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "PSY1000543",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04481",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036596300",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "417682100",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "417682101",
"state": "MD"
}
],
"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 Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.