Phylicia Wooten, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC10320 Issued in MD

Practice address

5510 Regency Place Suite 203
White Plains, MD 20695

Phone

(240) 419-2556

NPI assigned

Mar 27, 2017

Last updated

Apr 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minds Matter, LLC

  • Health Service Clinic/Center
  • Waldorf, MD
  • NPI 1578392429
  NPD (past) Authorized official

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1609307040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14640 GALLANT LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206015509",
            "telephone_number": "513-720-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 REGENCY PLACE SUITE 203",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "20695",
            "telephone_number": "240-419-2556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 M St SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200033609",
            "country_code": "US",
            "telephone_number": "202-547-3870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14640 Gallant Ln",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206015509",
            "country_code": "US",
            "telephone_number": "513-720-7447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1208 E Churchville Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "21014",
            "country_code": "US",
            "telephone_number": "410-893-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "PHYLICIA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "LGPC00235",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC10320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys Ann Wilkins, PA-C
• Andrea Michelle Williams, PSYD
• Ryleigh Elaine Wilson, PTA
• Mary Winkler
• Wooten Lyons LLC
• Huijing Yang
• Calondra Young
• Your Nu Image LLC

• Professional Counselor in White Plains, MD
• Providers in White Plains, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.