Tubarus Chisholm, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PRC14348 Issued in DC

Practice address

2200 Pennsylvania Ave NW
Washington, DC 20037-1709

Phone

(202) 441-0842

NPI assigned

Oct 17, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445126400000",
    "number": "1780088864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15765",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200030765",
            "telephone_number": "202-441-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371709",
            "telephone_number": "202-441-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "TUBARUS",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2015-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC14348",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH AND MENTAL HYGIENE",
            "identifier": "LC3626",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH LICENSING",
            "identifier": "PRC14348",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edith Chirino
• Lakshmi Gayathri Chirumamilla, MD
• Vikram Surya Chiruvolu, LGPC, MA, BSCS
• Briyana Chisholm
• Latisha Chisholm, LICSW
• Felicia Chising Epse Foncha
• Zuleima Chism, PT, DPT
• Paul Frederick Chisolm III
• Ami Chitalia, M.D.
• Sachin Babasaheb Chitalkar, MD

• Professional Counselor in Washington, DC
• Providers in Washington, DC by specialty
• Professional Counselor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2015; 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.