Individual provider Active NPI

Kathleen Daniels, PMHNP, IBCLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1063089613
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R219138 Issued in MD
Practice address
5301 Buckeystown Pike Ste 170
Frederick, MD 21704-8380
Phone
(240) 575-9688
NPI assigned
Jun 10, 2021
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R219138 MD Primary
Lactation Consultant (Registered Nurse) 163WL0100X L-149678 MD

Addresses

Primary practice location

5301 Buckeystown Pike Ste 170
Frederick, MD 21704-8380

Mailing address

6502 N Shore SQ
New Market, MD 21774-6443
Phone (617) 259-0282

Other practice location 1

6502 N Shore Sq
New Market, MD 21774-6443
Phone (617) 259-0282

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L-149678MDMDLactation Consultant (Registered Nurse)
R219138MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1063089613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 N SHORE SQ",
            "city": "NEW MARKET",
            "state": "MD",
            "postal_code": "217746443",
            "telephone_number": "617-259-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BUCKEYSTOWN PIKE STE 170",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048380",
            "telephone_number": "240-575-9688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6502 N Shore Sq",
            "address_purpose": "LOCATION",
            "city": "New Market",
            "state": "MD",
            "postal_code": "217746443",
            "country_code": "US",
            "telephone_number": "617-259-0282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "KATHLEEN",
        "credential": "PMHNP, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R219138",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "L-149678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.