Progressive Life Institute Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 1060 Issued in DC

Legal business name

PROGRESSIVE LIFE INSTITUTE INC

Practice address

1933 Montana Ave NE
Washington, DC 20002-1817

Phone

(202) 349-7663

Fax

(202) 842-0604

NPI assigned

Feb 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Frederick Brian Phillips, PSY.D.

Title

President

Phone

(202) 349-7663

Specialties & licenses 2

Addresses

Locations

Practitioners 3

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

• Tracy Ozzaline Garrett, PHD

  • Psychologist
  • Washington, DC
  • NPI 1427352145
  NPD (past)
• Paul Ime Inyang, LPC

  • Professional Counselor
  • Washington, DC
  • NPI 1548425440
  NPD (past)
• Shawan D Patterson Jackson, LPC

  • Mental Health Counselor
  • Washington, DC
  • NPI 1629459888
  NPD (past)

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1528426293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 MONTANA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021817",
            "telephone_number": "202-349-7663",
            "fax_number": "202-842-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 MONTANA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021817",
            "telephone_number": "202-349-7663",
            "fax_number": "202-842-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE LIFE INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-349-7663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY 1060",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC301232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressive Habilitative Services Inc. II
• Progressive Habilitative Services, Inc
• Progressive Healthcare Inc.
• Progressive Healthcare Inc.
• Progressive Life Center Inc.
• Progressive Medical Care Services Inc
• Progressive Physical Therapy Center
• Progressive Physical Therapy, LLC
• Kevin Andrew Prohaska, D.O.
• Nicole Prohaska

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.