NPIMap

Organization Active NPI

Wisconsin Ave Psychiatric Center Inc

  • Social Worker
  • Washington, DC
National Provider Identifier
1801279393
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
WISCONSIN AVE PSYCHIATRIC CENTER INC
Doing business as
Psychiatric Institute of Washington
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(202) 885-5600
Fax
(202) 885-5842
NPI assigned
Jul 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Authorized official

Name
Mr. Charles J Baumgardner
Title
Ceo
Phone
(202) 885-5600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X HFD01-0011 DC
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone (202) 885-5600

Other identifiers 6

IdentifierTypeStateIssuer
448740100MedicaidMD
569223OtherMEDICARE
026392500MedicaidDC
074500600MedicaidMD
208290000MedicaidMD
026402100MedicaidDC

Other names 1

  • Psychiatric Institute of Washington Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Psychiatric Institute7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1801279393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600",
            "fax_number": "202-885-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600",
            "fax_number": "202-885-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN AVE PSYCHIATRIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "BAUMGARDNER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-885-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "HFD01-0011",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448740100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "569223",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026392500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074500600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208290000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026402100",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Institute of Washington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 2, 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.