NPIMap

Organization Active NPI

SW Therapeutic Services, Inc.

  • Professional Counselor
  • Upper Marlboro, MD
National Provider Identifier
1770637647
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC1245 Issued in MD
Legal business name
SW THERAPEUTIC SERVICES, INC.
Practice address
17203 Clairfield LN
Upper Marlboro, MD 20772-3335
Phone
(301) 627-0568
Fax
(301) 780-5322
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Dr. Shannon Renee Williams, PH.D., LCPCNPI 1720130297
Title
President
Phone
(301) 627-0568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC1245 MD
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LC1245 MD Primary

Addresses

Primary practice location

17203 Clairfield LN
Upper Marlboro, MD 20772-3335

Mailing address

17203 Clairfield LN
Upper Marlboro, MD 20772-3335
Phone (301) 627-0568

Other identifiers 1

IdentifierTypeStateIssuer
013226800MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1770637647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17203 CLAIRFIELD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723335",
            "telephone_number": "301-627-0568",
            "fax_number": "301-780-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17203 CLAIRFIELD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723335",
            "telephone_number": "301-627-0568",
            "fax_number": "301-780-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SW THERAPEUTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-627-0568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC1245",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013226800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.