NPIMap

Organization Active NPI

Public Charter School Center for Student Support Services

  • Mental Health Counselor
  • Washington, DC
National Provider Identifier
1760503197
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
036394400 Issued in DC
Legal business name
PUBLIC CHARTER SCHOOL CENTER FOR STUDENT SUPPORT SERVICES
Practice address
1003 K St NW
Suite 405
Washington, DC 20001-4425
Phone
(202) 628-8848
Fax
(202) 628-8849
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Ms. Carolyn L Gardner II
Title
Executive Director
Phone
(202) 628-8848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 036394400 DC Primary

Addresses

Primary practice location

1003 K St NW
Suite 405
Washington, DC 20001-4425

Mailing address

1003 K St NW
Suite 405
Washington, DC 20001-4425
Phone (202) 628-8848

Other identifiers 1

IdentifierTypeStateIssuer
036394400MedicaidDC

Other names 1

  • Student Support Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Center for Student Support Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1760503197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 K ST NW",
            "address_2": "SUITE 405",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200014425",
            "telephone_number": "202-628-8848",
            "fax_number": "202-628-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 K ST NW",
            "address_2": "SUITE 405",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200014425",
            "telephone_number": "202-628-8848",
            "fax_number": "202-628-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC CHARTER SCHOOL CENTER FOR STUDENT SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "202-628-8848",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "036394400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036394400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Support Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 18, 2008; 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.