EBONY MACK (NPI# 1861023087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861023087 |
| Entity Type | Individual |
| Full Name | EBONY MACK |
| Credential | PSYD |
| Practice Address |
2041 Martin Luther King Jr Ave Se Washington DC 20020-7024 |
| Mailing Address |
11315 Kettering Ter Upper Marlboro MD 20774-1567 |
| Practice Telephone | 2025478450 |
| Mailing Telephone | 3019742286 |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-01-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSYA00343 | DC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225548910 | Ebony Mack | Technician | 1305 Congress St Se Apt 3, Washington, DC 20032-5059 | 2017-10-06 |
| Street Address |
2041 MARTIN LUTHER KING JR AVE SE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20020-7024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720058928 | Muhammad A Khalid | Podiatrist | 2041 Martin Luther King Jr Ave Se, Suite 103, Washington, DC 20020-7024 | 2006-01-23 |
| 1598379695 | Jason Deramo | Social Worker | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2020-09-04 |
| 1720609134 | Theresa Juanita Govan | Counselor | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2020-04-27 |
| 1821624198 | Debra Renee Harrison | Counselor | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2020-03-19 |
| 1760018139 | Michelle Renee Tolbert | Counselor | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2020-03-18 |
| 1972139384 | Janet A. Bolomope | Social Worker | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2020-03-17 |
| 1649822180 | Carole Darice Davis | Social Worker | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2019-07-15 |
| 1720630437 | Laura E Jeske | Dietitian, Registered | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2019-07-12 |
| 1508329897 | Arega Workneh Gera | Social Worker | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2019-04-12 |
| 1720545338 | Jimmie Cheavou Hayden | Counselor | 2041 Martin Luther King Jr Ave Se, Washington, DC 20020-7024 | 2019-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043834294 | Monique Holland | Community Health Worker | 3001 O Street Se, Washington, DC 20020 | 2020-06-03 |
| 1215566708 | Ryan Wright | Counselor | Integrated Behavioral Solutions Group Inc., 3200 S St. S.e., Washington, DC 20020 | 2020-04-06 |
| 1316581002 | Kamara King | Hospitalist | 2754 Bruce Pl Se, Washington, DC 20020 | 2019-11-05 |
| 1639720394 | Denise Anderson | Technician | 2401 Bryan Pl S.e, Washington, DC 20020 | 2019-09-24 |
| 1629628664 | Rayniece Ann Johnson | Technician | 1641 W.st Se #303, Washington, DC 20020 | 2019-09-11 |
| 1780245787 | Connie Kitchings | Technician | 2800 Shipley Terrace Se, Washington, DC 20020 | 2019-06-21 |
| 1922560366 | Neka Ramsey-lee | Counselor | Anacostia Community Health Center, 1500 Galen Street, Se, Washington, DC 20020 | 2019-04-04 |
| 1750843553 | Chloe Rebecca Zaitlin | Psychologist | 2600 Douglass Rd. Se, Washington, DC 20020 | 2019-04-02 |
| 1356814974 | Ferris Antwan Alston | Technician | 2100 Mlk Jr Ave S.e., Suite#100, Washington, DC 20020 | 2019-01-07 |
| 1083182471 | Aaron Joshua Jones | Technician | 1432 T Street Se, 1432 T Street Se, Washington, DC 20020 | 2018-11-05 |
| Find all providers in zip 20020 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900110 | Betsy Mencher, Ph.d. Pllc | Psychologist | 1350 Connecticut Ave Nw Ste 500, Washington, DC 20036-1736 | 2020-10-20 |
| 1083211130 | Malcolm Horace Woodland | Psychologist | 1815 N Capitol St Ne, Washington, DC 20002-1535 | 2020-10-01 |
| 1902416217 | Eric Todd Jones | Psychologist | 3220 15th St Ne, Washington, DC 20017-2936 | 2020-08-03 |
| 1811507148 | Michael Magenheimer | Psychologist | 4430 13th Pl Ne, Washington, DC 20017-2729 | 2020-08-02 |
| 1942827407 | Courtney Dinsmore | Psychologist | 6621 31st St Nw, Washington, DC 20015-2345 | 2020-07-01 |
| 1386265098 | John Loughlin-presnal | Psychologist | 37th and O Streets Nw One Darnall Hall, Washington, DC 20057-0001 | 2020-05-04 |
| 1457972242 | Holly Anne Weber | Psychologist | 4001 Harewood Rd Ne Rm 110, Washington, DC 20017-1508 | 2020-05-03 |
| 1609406248 | The Ludic Group | Psychologist | 1350 Connecticut Ave Nw Ste 307, Washington, DC 20036-1738 | 2020-01-23 |
| 1164060596 | Brigit Monica Van Widenfelt | Psychologist | 5208 41st St Nw, Washington, DC 20015-1902 | 2019-12-16 |
| 1205477700 | Kingston Psychological Services | Psychologist | 10 G St Ne Ste 600, Washington, DC 20002-4253 | 2019-10-05 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20020 |
Please comment or provide details below to improve the information on EBONY MACK.
| 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.