Organization Active NPI

Samuel Berkowitz, PH.D., Inc.

  • Clinical Psychologist
  • Ellicott City, MD
National Provider Identifier
1043417330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
461-MD Issued in MD
Legal business name
SAMUEL BERKOWITZ, PH.D., INC.
Practice address
5018 Dorsey Hall Dr
Suite 205
Ellicott City, MD 21042-7855
Phone
(410) 730-5138
Fax
(410) 997-0603
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Samuel Berkowitz, PH.D.
Title
Psychologist Owner
Phone
(410) 730-5138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 461-MD MD Primary

Addresses

Primary practice location

5018 Dorsey Hall Dr
Suite 205
Ellicott City, MD 21042-7855

Mailing address

5018 Dorsey Hall Dr
Suite 205
Ellicott City, MD 21042-7855
Phone (410) 730-5138

National Provider Directory

National Provider Directory

Locations

5036 Dorsey Hall Dr
Ste 104
Ellicott City, MD 21042
Phone (410) 730-5138

5018 Dorsey Hall Dr
Ellicott City, MD 21042
Phone (410) 992-4940

11584 Scaggsville Rd
#I
Fulton, MD 20759
Phone (301) 317-4854

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043417330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 DORSEY HALL DR",
            "address_2": "SUITE 205",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427855",
            "telephone_number": "410-730-5138",
            "fax_number": "410-997-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5018 DORSEY HALL DR",
            "address_2": "SUITE 205",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427855",
            "telephone_number": "410-730-5138",
            "fax_number": "410-997-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL BERKOWITZ, PH.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERKOWITZ",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PSYCHOLOGIST OWNER",
        "authorized_official_telephone_number": "410-730-5138",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "461-MD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.