Active NPI
Green Door, Inc
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1982740056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC302086
- Legal business name
- GREEN DOOR, INC
- Practice address
- 1221 Taylor St NW
Washington, DC 20011-5617 - Phone
- (202) 464-9200
- NPI assigned
- Jan 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael Clancy
- Title
- Deputy Director
- Phone
- (202) 464-9200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC302086 | DC | Primary |
Addresses
Primary practice location
1221 Taylor St NW
Washington, DC 20011-5617
Mailing address
1221 Taylor St NW
Washington, DC 20011-5617
Phone (202) 464-9200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23345 | Other | DC | CHARTERED HEALTH PLAN MCO |
| 52113 | Other | DC | AMERIGROUP (MEDICAID MCO) |
| 5234 | Other | DC | HEALTHRIGHT (MEDICAID MCO |
National Provider Directory
National Provider Directory- Tax ID family
- Green Door Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatry Physician
- Washington, DC
- NPI 1073659140
-
- Addiction (Substance Use Disorder) Counselor
- Washington, DC
- NPI 1790821866
-
- Professional Counselor
- Washington, DC
- NPI 1891841391
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Washington, DC
- NPI 1134261415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1982740056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 TAYLOR ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115617",
"telephone_number": "202-464-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 TAYLOR ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115617",
"telephone_number": "202-464-9200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN DOOR, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-29",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CLANCY",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "DEPUTY DIRECTOR",
"authorized_official_telephone_number": "202-464-9200",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC302086",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHARTERED HEALTH PLAN MCO",
"identifier": "23345",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP (MEDICAID MCO)",
"identifier": "52113",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHRIGHT (MEDICAID MCO",
"identifier": "5234",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.