Individual provider Active NPI

Tiffany Wen-Ting Lin, PSY.D

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1003155540
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05316 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1832
Phone
(443) 923-9200
Fax
(443) 923-1895
NPI assigned
Feb 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05316 MD Primary

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1832

Mailing address

2931 E Biddle St
Baltimore, MD 21213-3939
Phone (443) 923-1886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240205000007 MD Practitioner - Clinical Psychologist 6002259355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05316MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Dec 26, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Dec 26, 2023 Accepting new patients

Locations

1741 Ashland Ave
Ste 642
Baltimore, MD 21205

2931 E Biddle St
Baltimore, MD 21213
Phone (443) 923-1872

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

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": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1003155540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 E BIDDLE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212133939",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-9200",
            "fax_number": "443-923-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "TIFFANY",
        "middle_name": "WEN-TING",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.