Innercity Collaborative Community Development Corporation

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

INNERCITY COLLABORATIVE COMMUNITY DEVELOPMENT CORPORATION

Doing business as

Homes With A real Heart
Miracle Temple Non Denominational Church Inc.

Practice address

5219 Call PL SE
Washington, DC 20019-6321

Phone

(240) 304-6822

Fax

(301) 336-5164

NPI assigned

Jan 22, 2024

Last updated

Jan 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rev Judie Shepherd-Gore, JD, MBA

Title

Executive Director

Phone

(240) 304-6822

Specialties & licenses 6

Addresses

Other names 2

• Homes With A real Heart Doing business as
• Miracle Temple Non Denominational Church Inc. Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sharon J Daniel, LISW

  • Counselor
  • Washington, DC
  • NPI 1356105381
  NPD

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1477314011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CALL PL SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200196321",
            "telephone_number": "240-304-6822",
            "fax_number": "301-336-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 CALL PL SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200196321",
            "telephone_number": "240-304-6822",
            "fax_number": "301-336-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Banks Pl NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200196636",
            "country_code": "US",
            "telephone_number": "202-270-3862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNERCITY COLLABORATIVE COMMUNITY DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-20",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD-GORE",
        "authorized_official_first_name": "REV JUDIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-304-6822",
        "authorized_official_credential": "JD, MBA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homes With A real Heart",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miracle Temple Non Denominational Church Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inner Balance Mental Health Solutions, LLC
• Inner City Family Services LLC
• Inner City Family Services LLC
• Inner Harmony Group, LLC
• Inner Power Health Therapeutic Services
• Innerstate Psychiatry, PLLC
• Trystan Alisdair Innes, MD
• Christina Innocent
• Innovated Healthcare Services
• Innovation Care, LLC

• Counselor in Washington, DC
• Providers in Washington, DC by specialty
• Counselor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.