Individual provider Active NPI

Candice D Grace-Lee, M.D.

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1023070414
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0034640 Issued in MD
Practice address
9105 Franklin Square Dr
Suites 102/103
Baltimore, MD 21237-3930
Phone
(443) 777-7878
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0034640 MD Primary

Addresses

Primary practice location

9105 Franklin Square Dr
Suites 102/103
Baltimore, MD 21237-3930

Mailing address

9105 Franklin Square Dr
Suites 102/103
Baltimore, MD 21237-3930
Phone (443) 777-7878

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081022000164 MD Practitioner - Psychiatry 2961570098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Duke University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Marsh Psychiatric Associates, LLCGroup PAC ID 3072681105, 10 clinicians

Practice addresses (Care Compare)

5024 Campbell Blvd
Baltimore, MD 21236-5974
Phone (410) 931-9280

5024 Campbell Boulevard
Suite H
Baltimore, MD 21236-5974

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 9, 2017 Accepting new patients
White Marsh Psychiatric Associates, LLC Psychiatry CurrentSince Oct 1, 2008 Accepting new patients
Franklin Square Hospital Center Inc Current Accepting new patients
Bay Life Services Corporation Past Accepting new patients

Locations

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

5024 Campbell Blvd
Ste H
Nottingham, MD 21236
Phone (410) 569-9201

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

9105 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 574-1330

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1023070414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 FRANKLIN SQUARE DR",
            "address_2": "SUITES 102/103",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373930",
            "telephone_number": "443-777-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 FRANKLIN SQUARE DR",
            "address_2": "SUITES 102/103",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373930",
            "telephone_number": "443-777-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE-LEE",
        "first_name": "CANDICE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0034640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.