Eliza Staley

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R250258 Issued in MD

Practice address

4520 E West Hwy Ste 775
Bethesda, MD 20814-0066

Phone

(667) 668-2566

NPI assigned

Jan 2, 2013

Reactivated

Jul 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Psych Associates of Maryland LLC

  • Psychologist
  • Timonium, MD
  • NPI 1891721981
  NPD

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1013253558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 100",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744785",
            "telephone_number": "301-691-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 E WEST HWY STE 775",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208140066",
            "telephone_number": "667-668-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "ELIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "deactivation_date": "2023-05-23",
        "reactivation_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R250258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilbur Henry Stafford, IDC
• David Richard Stagliano, M.D.
• Michael S Stagliano, ARNP
• Amy Lynn Stahl, MS, RD, LD
• Lauren Stahly
• Elizabeth Stalker, M.S. CCC-SLP
• Amanda Tyler Stallone, MD
• Daphne Stamos Keshishian, MD
• Adrienne Marie Stamper
• John Michael Stanavage, DO

• Psychiatric/Mental Health Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.