NPIMap

Organization Active NPI

D.a. Wynne & Associates,Inc.

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1609359389
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
D.A. WYNNE & ASSOCIATES,INC.
Practice address
11900 Parklawn Dr Ste 120
Rockville, MD 20852-2668
Phone
(301) 468-5663
NPI assigned
Sep 10, 2018
Organization subpart
Yes
Parent organization
D.A. WYNNE & ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Authorized official

Name
Elizabeth C Krueger, LCSW-C, MPHNPI 1700363223
Title
Clinical Director
Phone
(301) 439-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11900 Parklawn Dr Ste 120
Rockville, MD 20852-2668

Mailing address

11900 Parklawn Dr Ste 120
Rockville, MD 20852-2668
Phone (301) 468-5663

Other identifiers 2

IdentifierTypeStateIssuer
1457474017MedicaidMD
1700363223MedicaidMD

Other names 1

  • The Silver Spring Outpatient Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Da Wynne Associatesinc4 organizations share this tax ID, including this one
Part of
Da Wynne Associatesinc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11900 Parklawn Dr
Ste 120
Rockville, MD 20852
Phone (301) 468-5663

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1609359389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 PARKLAWN DR STE 120",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522668",
            "telephone_number": "301-468-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 PARKLAWN DR STE 120",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522668",
            "telephone_number": "301-468-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.A. WYNNE & ASSOCIATES,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "D.A. WYNNE & ASSOCIATES, INC.",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "301-439-6700",
        "authorized_official_credential": "LCSW-C, MPH"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457474017",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700363223",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Silver Spring Outpatient Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.