Proactive Psychiatry LC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PROACTIVE PSYCHIATRY LC

Practice address

1718 Connecticut Ave NW Ste 201
Washington, DC 20009-1148

Phone

(202) 640-5502

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Ryan SheridanNPI 1871225789

Title

Principal Clinician & Ceo

Phone

(202) 640-5502

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Sheridan, NP

  • Nurse Practitioner
  • Washington, DC
  • NPI 1871225789
  NPD Authorized official

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1902656929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 K ST NW STE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 CONNECTICUT AVE NW STE 201",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091148",
            "telephone_number": "202-640-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "telephone_number": "202-640-5502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROACTIVE PSYCHIATRY LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRINCIPAL CLINICIAN & CEO",
        "authorized_official_telephone_number": "202-640-5502"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.