NPIMap

Organization Active NPI

Cathryne L. Maciolek, Psy.D., LLC

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1053703298
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05298 Issued in MD
Legal business name
CATHRYNE L. MACIOLEK, PSY.D., LLC
Practice address
540 E. Belvedere Avenue
Suite 203
Baltimore, MD 21212
Phone
(410) 591-5380
NPI assigned
Feb 25, 2015
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Dr. Cathryne L Maciolek, PSY.D.
Title
Principal
Phone
(410) 591-5380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05298 MD Primary

Addresses

Primary practice location

540 E. Belvedere Avenue
Suite 203
Baltimore, MD 21212

Mailing address

540 E Belvedere Ave
Suite 203
Baltimore, MD 21212-3750
Phone (410) 591-5380

Other identifiers 1

IdentifierTypeStateIssuer
393635OtherMEDICARE PTAN

Other names 1

  • The Mandala Center: Behavioral Health & Wellness Other name

National Provider Directory

National Provider Directory

Locations

540 E Belvedere Ave
Ste 203
Baltimore, MD 21212
Phone (443) 926-9115

Practitioners & affiliated clinicians

Practitioners 3

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": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1053703298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 E BELVEDERE AVE",
            "address_2": "SUITE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123750",
            "telephone_number": "410-591-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E. BELVEDERE AVENUE",
            "address_2": "SUITE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21212",
            "telephone_number": "410-591-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHRYNE L. MACIOLEK, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "MACIOLEK",
        "authorized_official_first_name": "CATHRYNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "410-591-5380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "393635",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mandala Center: Behavioral Health & Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 2, 2015; 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.