Individual provider Active NPI

Krishtine Rosenthal, PH.D.

  • Clinical Psychologist
  • Rockville, MD
National Provider Identifier
1013441880
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06043 Issued in MD
Practice address
50 W Montgomery Ave Ste 110
Rockville, MD 20850-4248
Phone
(301) 610-7850
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 06043 MD Primary
Clinical Psychologist 103TC0700X PSY1001575 DC

Addresses

Primary practice location

50 W Montgomery Ave Ste 110
Rockville, MD 20850-4248

Mailing address

50 W Montgomery Ave Ste 110
Rockville, MD 20850-4248

Other practice location 1

825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914
Phone (757) 446-5881

Other practice location 2

Kennedy Krieger Institute
9730 Patuxent Woods Dr
Columbia, MD 21046
Phone (443) 923-9200

Other practice location 3

935 Redgate Ave
Norfolk, VA 23507-1517
Phone (757) 668-6123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 23, 2025 through Sep 23, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1001575DCMDClinical Psychologist
06043MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1013441880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504248",
            "telephone_number": "301-610-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave",
            "address_2": "Suite 710",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071914",
            "country_code": "US",
            "telephone_number": "757-446-5881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Kennedy Krieger Institute",
            "address_2": "9730 Patuxent Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "21046",
            "country_code": "US",
            "telephone_number": "443-923-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 Redgate Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071517",
            "country_code": "US",
            "telephone_number": "757-668-6123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "KRISHTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06043",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1001575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.