NPIMap

Organization Active NPI

Psychological Assessment, Consultation, and Evaluation, LLC

  • Clinical Psychologist
  • Odenton, MD
National Provider Identifier
1063924637
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05015 Issued in MD
Legal business name
PSYCHOLOGICAL ASSESSMENT, CONSULTATION, AND EVALUATION, LLC
Practice address
1214 Gregory CT
Odenton, MD 21113-1754
Phone
(443) 698-8326
NPI assigned
Nov 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Shannon Senefeld, PSY.D.NPI 1700124591
Title
Owner
Phone
(443) 698-8326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X 05015 MD
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X 05015 MD
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 05015 MD Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 05015 MD
Health PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0004X 05015 MD
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X 05015 MD

Addresses

Primary practice location

1214 Gregory CT
Odenton, MD 21113-1754

Mailing address

1214 Gregory CT
Odenton, MD 21113-1754
Phone (443) 698-8326

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1063924637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 GREGORY CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131754",
            "telephone_number": "443-698-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 GREGORY CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131754",
            "telephone_number": "443-698-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSESSMENT, CONSULTATION, AND EVALUATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "SENEFELD",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-698-8326",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MD",
            "license": "05015",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MD",
            "license": "05015",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05015",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "05015",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": "MD",
            "license": "05015",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MD",
            "license": "05015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.