Paradigm Shift Psychological Wellness Collective PC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

PARADIGM SHIFT PSYCHOLOGICAL WELLNESS COLLECTIVE PC

Practice address

3703 40TH PL
Brentwood, MD 20722-1610

Phone

(602) 628-7008

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Delishia Markayle Pittman, PHD

Title

Psychologist and Owner

Phone

(202) 930-2134

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1952999203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 40TH PL",
            "city": "BRENTWOOD",
            "state": "MD",
            "postal_code": "207221610",
            "telephone_number": "602-628-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 40TH PL",
            "city": "BRENTWOOD",
            "state": "MD",
            "postal_code": "207221610",
            "telephone_number": "602-628-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADIGM SHIFT PSYCHOLOGICAL WELLNESS COLLECTIVE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "DELISHIA",
        "authorized_official_middle_name": "MARKAYLE",
        "authorized_official_title_or_position": "PSYCHOLOGIST AND OWNER",
        "authorized_official_telephone_number": "202-930-2134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 4, 2021; 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.