NPIMap

William Wendt Center for Loss and Healing

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Washington, DC

NPI 1710040720 · NPPES record last updated Jul 27, 2020

Key facts

NPI
1710040720
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
WILLIAM WENDT CENTER FOR LOSS AND HEALING
Practice address
4201 Connecticut Avenue NW
Suite 300
Washington, DC 20008-1162
Phone
(202) 624-0010
Fax
(202) 624-0062
NPI assigned
Dec 19, 2006
Organization subpart
No

Authorized official

Name
Jerri L Anglin, LICSW
Title
Director of Clinical Services
Phone
(202) 422-8063

Corporate family (same tax ID) 2

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

Practitioners 17

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040610000349 DC Part B Supplier - Clinic/Group Practice 3870576986 Receives reassigned benefits from 15 practitioners
Practice locations: Washington, DC

National Provider Directory

Tax ID family
Wendt Center (3 organizations share this tax ID)

Locations

730 11th St NW
Fl 3
Washington, DC 20001
Phone (202) 624-0010

1640 Kalmia Rd NW
Washington, DC 20012
Phone (202) 291-1975

4201 Connecticut Ave NW
Ste 300
Washington, DC 20008
Phone (202) 624-0010

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

4201 Connecticut Avenue NW
Suite 300
Washington, DC 20008-1162

Mailing address

4201 Connecticut Avenue NW
Suite 300
Washington, DC 20008-1162
Phone (202) 624-0010

Other identifiers

IdentifierTypeStateIssuer
037516200MedicaidDC

Other names

  • St Francis Center Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 27, 2020.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1710040720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CONNECTICUT AVENUE NW",
            "address_2": "SUITE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081162",
            "telephone_number": "202-624-0010",
            "fax_number": "202-624-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CONNECTICUT AVENUE NW",
            "address_2": "SUITE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081162",
            "telephone_number": "202-624-0010",
            "fax_number": "202-624-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM WENDT CENTER FOR LOSS AND HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "ANGLIN",
        "authorized_official_first_name": "JERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "202-422-8063",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037516200",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Francis Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "St Francis Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Washington, DC

All providers in Washington, DC · Mental Health Clinic/Center (Including Community Mental Health Center) in District of Columbia

Sources for this page

Verify at the official NPI Registry.