Individual provider Active NPI

Ashlae L Portell, PHD, LP

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1013638154
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
07351 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1888
Phone
(443) 923-1870
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 07351 MD Primary

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1888

Mailing address

1741 Ashland Ave
Attn: Patient Accounting
Baltimore, MD 21205-1531
Phone (616) 835-1964

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
I20250909001505 MD Practitioner - Clinical Psychologist 4082116975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1741 Ashland Ave
Baltimore, MD 21205-1531

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07351MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Sep 1, 2025 Accepting new patients
Kennedy Krieger Associates CurrentSince Sep 1, 2025 Accepting new patients

Locations

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

1741 Ashland Ave
Ste 642
Baltimore, MD 21205

1741 Ashland Ave
Baltimore, MD 21205
Phone (443) 923-1842

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1013638154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "address_2": "ATTN: PATIENT ACCOUNTING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051531",
            "telephone_number": "616-835-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051888",
            "telephone_number": "443-923-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELL",
        "first_name": "ASHLAE",
        "middle_name": "L",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "07351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.