Active NPI
Traci Edwardson Callandrillo, PH.D.
- Counseling Psychologist
- Washington, DC
National Provider Identifier
1447531371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY1000433
- Practice address
- 4545 42ND St NW
Suite 202
Washington, DC 20016-4623 - Phone
- (512) 534-8605
- NPI assigned
- Sep 6, 2011
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY1000433 | DC | Primary |
Addresses
Primary practice location
4545 42ND St NW
Suite 202
Washington, DC 20016-4623
Mailing address
4545 42ND St NW
Suite 202
Washington, DC 20016-4623
Phone (512) 534-8605
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1000433 | DC | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1447531371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 42ND ST NW",
"address_2": "SUITE 202",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200164623",
"telephone_number": "512-534-8605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 42ND ST NW",
"address_2": "SUITE 202",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200164623",
"telephone_number": "512-534-8605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLANDRILLO",
"first_name": "TRACI",
"middle_name": "EDWARDSON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "DC",
"license": "PSY1000433",
"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 Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.