Individual provider Active NPI

Christine Yvonne Wiley, PH.D

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1972932713
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50081044 Issued in DC
Practice address
3845 S Capitol St SW
Washington, DC 20032-1419
Phone
(202) 562-4640
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PRC814 DC
Clinical Social Worker 1041C0700X LC50081044 DC Primary

Addresses

Primary practice location

3845 S Capitol St SW
Washington, DC 20032-1419

Mailing address

4119 Steeds Grant Way
Fort Washington, MD 20744-1401
Phone (301) 404-1842

Other names 1

  • Dr. Christine Yvonne Wiley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922003023 DC Practitioner - Clinical Social Worker 1153706437 Practice locations: Fort Washington, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Fort Washington, MD 20744
Phone (301) 404-1842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PRC814DCMDProfessional Counselor
25402MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1972932713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 STEEDS GRANT WAY",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207441401",
            "telephone_number": "301-404-1842",
            "fax_number": "301-248-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 S CAPITOL ST SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321419",
            "telephone_number": "202-562-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "CHRISTINE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC814",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "WILEY",
            "middle_name": "YVONNE",
            "prefix": "DR.",
            "credential": "PH.D., LPC, LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.