International Diagnostic Solutions

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

INTERNATIONAL DIAGNOSTIC SOLUTIONS

Practice address

641 S St NW
Third Floor
Washington, DC 20001-5131

Phone

(202) 643-7462

NPI assigned

Jan 28, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Tracey Ellis, OTR/L, MPH

Title

Cofounder

Phone

(202) 202-6537

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1912397001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 S ST NW FL 3",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200015196",
            "telephone_number": "202-262-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 S ST NW",
            "address_2": "THIRD FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200015131",
            "telephone_number": "202-643-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL DIAGNOSTIC SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "COFOUNDER",
        "authorized_official_telephone_number": "202-202-6537",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L, MPH"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.