Active NPI
Jacinta A. Coleman, MSW, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1710921762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 302697
- Practice address
- 3825 17TH PL NE
Washington, DC 20018-2313 - Phone
- (202) 529-1572
- Fax
- (202) 529-0105
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 302697 | DC | Primary |
Addresses
Primary practice location
3825 17TH PL NE
Washington, DC 20018-2313
Mailing address
3825 17TH PL NE
Washington, DC 20018-2313
Phone (202) 529-1572
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24088 | Other | DC | CLINICAL SOCIAL WORKER |
| 268813 | Other | DC | CLINICAL SOCIAL WORKER |
| 5418 | Other | DC | CLINICAL SOCIAL WORKER |
| M36800001 | Other | DC | SOCIAL WORKER CLINICAL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302697 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710921762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3825 17TH PL NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200182313",
"telephone_number": "202-529-1572",
"fax_number": "202-529-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3825 17TH PL NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200182313",
"telephone_number": "202-529-1572",
"fax_number": "202-529-0105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "JACINTA",
"middle_name": "A.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "302697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL SOCIAL WORKER",
"identifier": "24088",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL SOCIAL WORKER",
"identifier": "268813",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL SOCIAL WORKER",
"identifier": "5418",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORKER CLINICAL",
"identifier": "M36800001",
"state": "DC"
}
],
"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.