NPIMap

Organization Active NPI

Chesapeake Bay Psychological Services LLC

  • Psychologist
  • Stevensville, MD
National Provider Identifier
1003938846
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
03850 Issued in MD
Legal business name
CHESAPEAKE BAY PSYCHOLOGICAL SERVICES LLC
Practice address
155 Log Canoe Cir
Stevensville, MD 21666
Phone
(410) 604-0226
Fax
(877) 643-0126
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Dr. Catherine Marie Smithmyer, PHDNPI 1922164177
Title
Owner Psychologist
Phone
(410) 604-0226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 03850 MD Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 03850 MD
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 03850 MD
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X 03850 MD

Addresses

Primary practice location

155 Log Canoe Cir
Stevensville, MD 21666

Mailing address

155 Log Canoe Cir
Stevensville, MD 21666-2127
Phone (410) 604-0226

Other identifiers 1

IdentifierTypeStateIssuer
1922164177OtherINDIVIDUAL NPI OF OWNER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110614000175 MD Part B Supplier - Clinic/Group Practice 3274710512 Receives reassigned benefits from 14 practitioners
Practice locations: Stevensville, MD

National Provider Directory

National Provider Directory

Locations

155 Log Canoe Cir
Stevensville, MD 21666
Phone (410) 604-0226

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1003938846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 LOG CANOE CIR",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662127",
            "telephone_number": "410-604-0226",
            "fax_number": "877-643-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 LOG CANOE CIR",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "21666",
            "telephone_number": "410-604-0226",
            "fax_number": "877-643-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE BAY PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "SMITHMYER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER PSYCHOLOGIST",
        "authorized_official_telephone_number": "410-604-0226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MD",
            "license": "03850",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "03850",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "03850",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "MD",
            "license": "03850",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI OF OWNER",
            "identifier": "1922164177",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.