Individual provider Active NPI

Sarah U. Mintz, PHD

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1609308667
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1000800 Issued in DC
Practice address
5247 Wisconsin Ave NW
Suite 4
Washington, DC 20015-2012
Phone
(202) 686-7699
Fax
(202) 362-9633
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1000800 DC Primary

Addresses

Primary practice location

5247 Wisconsin Ave NW
Suite 4
Washington, DC 20015-2012

Mailing address

5247 Wisconsin Ave NW
Suite 4
Washington, DC 20015-2012
Phone (202) 686-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2020 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1000800DCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Wake Kendall Group, PLLC Clinical Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1609308667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 WISCONSIN AVE NW",
            "address_2": "SUITE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152012",
            "telephone_number": "202-686-7699",
            "fax_number": "202-362-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 WISCONSIN AVE NW",
            "address_2": "SUITE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152012",
            "telephone_number": "202-686-7699",
            "fax_number": "202-362-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "SARAH",
        "middle_name": "U.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "1000800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.