NPIMap

Organization Active NPI

Green Door Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Washington, DC
National Provider Identifier
1801925193
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GREEN DOOR BEHAVIORAL HEALTH
Practice address
1221 Taylor St NW
Washington, DC 20011-5617
Phone
(202) 464-9200
Fax
(202) 464-5740
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Mr. Richard Bebout, PH.D.
Title
Ceo
Phone
(202) 464-9200

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 54000690 DC
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X DC Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X DC

Addresses

Primary practice location

1221 Taylor St NW
Washington, DC 20011-5617

Mailing address

1221 Taylor St NW
Washington, DC 20011-5617
Phone (202) 464-9200

Other identifiers 2

IdentifierTypeStateIssuer
057062300MedicaidDC
036561200MedicaidDC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1801925193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 TAYLOR ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115617",
            "telephone_number": "202-464-9200",
            "fax_number": "202-464-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 TAYLOR ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115617",
            "telephone_number": "202-464-9200",
            "fax_number": "202-464-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DOOR BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "BEBOUT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-464-9200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "DC",
            "license": "54000690",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "DC",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "DC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057062300",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036561200",
            "state": "DC"
        }
    ],
    "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 May 5, 2016; 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.