JASON R WALLIS (NPI# 1942707500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942707500 |
| Entity Type | Individual |
| Full Name | JASON R WALLIS |
| Credential | MSW, LICSW |
| Practice Address |
4414 Benning Rd Ne Washington DC 20019-4555 |
| Practice Telephone | 2023887759 |
| Mailing Telephone | 2023887759 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2019-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LC50081298 | DC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396913331 | Jason David Wallis | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2008-02-12 |
| Street Address |
4414 BENNING RD NE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20019-4555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386782563 | Unity Health Care, Inc | Clinic/Center | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2007-02-01 |
| 1922576008 | Unity Health Care, Inc. | Durable Medical Equipment & Medical Supplies | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2018-11-07 |
| 1033630124 | John Roxborough Iv | Family Medicine | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2017-06-29 |
| 1902330566 | Jayaprada Kasaraneni | Family Medicine | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2017-04-20 |
| 1023541620 | Monica Ajinkya | Family Medicine | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2017-04-10 |
| 1699137752 | Angelique Lynch-jiles | Family Medicine | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2016-03-28 |
| 1578950390 | Patricia Green | Pediatrics | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2015-04-20 |
| 1033505342 | Joseph Muller | Internal Medicine | 4414 Benning Rd Ne, Washington, DC 20019-4555 | 2015-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079440 | Gracefully Fulfilled Counseling and Coaching Services | Counselor | 219 56th Place Ne, Washington, DC 20019 | 2020-09-25 |
| 1033735170 | Regenia Elizabeth Sayles | Home Health Aide | 3924 Minnesota Ave Ne Washington, Dc, DC 20019 | 2020-06-24 |
| 1417578733 | Alycia Paige Heiner | Student in an Organized Health Care Education/Training Program | Parkside Health Center, 765 Kenilworth Terrace Ne, Washington, DC 20019 | 2020-04-27 |
| 1598398786 | Issa Munu | Technician | 45th Street Ne, 604, Washington, DC 20019 | 2020-02-17 |
| 1538708391 | Chanda Constance Mcmahan | Psychologist | 3320 Ames St. N.e., Washington, DC 20019 | 2019-12-27 |
| 1215582978 | Howard University | Clinic/Center | 4414-4430 Benning Road, Ne, Washington, DC 20019 | 2019-08-08 |
| 1255985776 | Kemba Kelton | Technician | 3204 1/2 East Capitol Street Nw, Washington, DC 20019 | 2019-08-01 |
| 1659930196 | Brittany Deshanta Fleming | Counselor | 1561 45th St Ne, Washington, DC 20019 | 2019-06-09 |
| 1346701299 | Chelsie Esek | Speech-Language Pathologist | 1234 Singleton Blvd., Washington Dc, DC 20019 | 2019-03-25 |
| 1174081434 | Kathleen Estelle Williams | Nurse's Aide | 12045th Street North East, 613, Washington, DC 20019 | 2019-03-06 |
| Find all providers in zip 20019 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254769 | Ayana E Thompson | Social Worker | 706 Burns St Se, Washington, DC 20019-4913 | 2020-10-27 |
| 1265030282 | Amy Killy | Social Worker | 5402 Connecticut Ave Nw Ste 102, Washington, DC 20015-2830 | 2020-10-12 |
| 1144828385 | Ann Morrison | Social Worker | 5333 Connecticut Ave Nw Apt 528, Washington, DC 20015-1895 | 2020-10-10 |
| 1225645591 | Rs Davis Health & Wellness, LLC | Social Worker | 3200 Martin Luther King Jr Ave Se, Washington, DC 20032-1538 | 2020-09-30 |
| 1114534716 | Beth Anne Henson | Social Worker | 2717 Unicorn Ln Nw, Washington, DC 20015-2233 | 2020-09-28 |
| 1588271407 | Andrew Thomas | Social Worker | 801 Pa Ave Se, Washington, DC 20003-2167 | 2020-09-24 |
| 1043826324 | Wellness Reset Solutions LLC | Social Worker | 255 Carroll St Nw Apt 552, Washington, DC 20012-2093 | 2020-09-21 |
| 1487266995 | Martha Johnson | Social Worker | 1555 Connective Ave Nw, #500w, Washington, DC 20036 | 2020-08-18 |
| 1538779863 | Moore Therapeutic and Consulting Services | Social Worker | 1600 Maryland Ave Ne Apt 257, Washington, DC 20002-7662 | 2020-08-02 |
| 1992313266 | Paula Nicole Thomason | Social Worker | 4407 2nd St Ne Apt 2, Washington, DC 20011-5142 | 2020-07-22 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20019 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.