The Soul Remediation Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE SOUL REMEDIATION CENTER LLC

Practice address

1629 K St NW
Washington, DC 20006-1602

Phone

(202) 751-6444

NPI assigned

Jun 5, 2019

Organization subpart

No

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

Authorized official

Name

Kean Glen Oliver Baxter, LICSWNPI 1831543719

Title

Owner

Phone

(202) 751-6444

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kean Baxter, MSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1831543719
  NPD (past) Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1497313282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 WEST ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204414",
            "telephone_number": "202-751-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 K ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061602",
            "telephone_number": "202-751-6444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4921 Colonel Contee Pl",
            "address_purpose": "LOCATION",
            "city": "Upper Marlboro",
            "state": "MD",
            "postal_code": "207722875",
            "country_code": "US",
            "telephone_number": "202-751-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE SOUL REMEDIATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "KEAN",
        "authorized_official_middle_name": "GLEN OLIVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-751-6444",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.