NPIMap

Organization Active NPI

Jaxcyn Therapy Group

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1972174258
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JAXCYN THERAPY GROUP
Practice address
6340 Security Blvd Ste 100
Baltimore, MD 21207-5284
Phone
(571) 867-0075
Fax
(202) 318-0667
NPI assigned
Jul 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Ta'Wane Watkins, LICSWNPI 1134639693
Title
Therapist
Phone
(571) 867-0075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6340 Security Blvd Ste 100
Baltimore, MD 21207-5284

Mailing address

1520 Belle View Blvd # 5011
Alexandria, VA 22307-6530
Phone (571) 867-0075

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1972174258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 BELLE VIEW BLVD # 5011",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223076530",
            "telephone_number": "571-867-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075284",
            "telephone_number": "571-867-0075",
            "fax_number": "202-318-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAXCYN THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "TA'WANE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "571-867-0075",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.