Individual provider Active NPI

Jennifer Grosman, PH.D.

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1609900745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1000150 Issued in DC
Practice address
4545 Connecticut Ave NW
Suite 417
Washington, DC 20008-6042
Phone
(202) 363-8200
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY1000150 DC Primary

Addresses

Primary practice location

4545 Connecticut Ave NW
Suite 417
Washington, DC 20008-6042

Mailing address

4225 49TH St NW
Washington, DC 20016-2343
Phone (202) 537-6645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY1000150DCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609900745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 49TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162343",
            "telephone_number": "202-537-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CONNECTICUT AVE NW",
            "address_2": "SUITE 417",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200086042",
            "telephone_number": "202-363-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSMAN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.