Individual provider Active NPI

Bianca Fetherson, PH.D.

  • Psychologist
  • Lanham, MD
National Provider Identifier
1003154691
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
7404 Executive PL Ste 225B
Lanham, MD 20706-6205
Phone
(240) 929-4387
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

7404 Executive PL Ste 225B
Lanham, MD 20706-6205

Mailing address

7404 Executive PL Ste 225B
Lanham, MD 20706-6205
Phone (240) 929-4387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05619MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fetherson & Knight Psychological Services, LLC Psychologist CurrentSince Sep 25, 2019 Accepting new patients
Honour Thyself Counseling & Psychological Services, LLC Psychologist Current Accepting new patients

Locations

7404 Executive Pl
Ste 225B
Lanham, MD 20706
Phone (240) 929-4387

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1003154691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL STE 225B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066205",
            "telephone_number": "240-929-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL STE 225B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066205",
            "telephone_number": "240-929-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHERSON",
        "first_name": "BIANCA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.