Active NPI
Lawrence David Heller, PH.D.
- Psychologist
- Baltimore, MD
National Provider Identifier
1023179223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3500
- Practice address
- 600 Wyndhurst Ave
Ste 307a
Baltimore, MD 21210-2419 - Phone
- (410) 243-5279
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3500 | MD | Primary |
Addresses
Primary practice location
600 Wyndhurst Ave
Ste 307a
Baltimore, MD 21210-2419
Mailing address
711 W 40TH St
456-B
Baltimore, MD 21211-2120
Phone (410) 243-5279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3500 | MD | MD | Psychologist |
| 03500 | MD | MD | Clinical Social Worker |
| MD | MD | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1023179223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W 40TH ST",
"address_2": "456-B",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112120",
"telephone_number": "410-243-5279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WYNDHURST AVE",
"address_2": "STE 307A",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212102419",
"telephone_number": "410-243-5279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLER",
"first_name": "LAWRENCE",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "3500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.