Individual provider Active NPI

Ellen Ford Wiggins, MSW, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1740478353
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC301853 Issued in DC
Practice address
1901 Mississippi Ave SE
Suite #104
Washington, DC 20020-6117
Phone
(202) 436-3060
Fax
(202) 610-9522
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC301853 DC Primary

Addresses

Primary practice location

1901 Mississippi Ave SE
Suite #104
Washington, DC 20020-6117

Mailing address

8913 Loughran Ter
Fort Washington, MD 20744-5639
Phone (202) 253-4636

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

State licenses

LicenseStateTypeSpecialty
LC301853DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1740478353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 LOUGHRAN TER",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445639",
            "telephone_number": "202-253-4636",
            "fax_number": "301-203-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MISSISSIPPI AVE SE",
            "address_2": "SUITE #104",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200206117",
            "telephone_number": "202-436-3060",
            "fax_number": "202-610-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "ELLEN",
        "middle_name": "FORD",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC301853",
            "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 Oct 9, 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.