Individual provider Active NPI

Jonathan Charles Stillerman, PH.D.

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1871776971
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1934 Issued in DC
Practice address
1301 Connecticut Ave NW
Suite 750
Washington, DC 20036-1815
Phone
(202) 429-4939
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY1934 DC Primary

Addresses

Primary practice location

1301 Connecticut Ave NW
Suite 750
Washington, DC 20036-1815

Mailing address

1301 Connecticut Ave NW
Suite 750
Washington, DC 20036-1815
Phone (202) 429-4939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1934DCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1871776971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONNECTICUT AVE NW",
            "address_2": "SUITE 750",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361815",
            "telephone_number": "202-429-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CONNECTICUT AVE NW",
            "address_2": "SUITE 750",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361815",
            "telephone_number": "202-429-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLERMAN",
        "first_name": "JONATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1934",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 11, 2007; 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.