NPIMap

Organization Active NPI

University Psychological Center, Inc

  • Psychiatry Physician
  • Frederick, MD
National Provider Identifier
1073030581
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UNIVERSITY PSYCHOLOGICAL CENTER, INC
Practice address
425 E Patrick St
Frederick, MD 21701-5729
Phone
(301) 662-7003
Fax
(301) 694-8527
NPI assigned
Aug 25, 2017
Last updated
Aug 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Authorized official

Name
Dr. Clark J Hudak Jr., PH.D.NPI 1598786329
Title
President/Ceo
Phone
(410) 576-9191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

425 E Patrick St
Frederick, MD 21701-5729

Mailing address

6201 Greenbelt Rd Ste U18
Berwyn Heights, MD 20740-2361
Phone (301) 345-1919

National Provider Directory

National Provider Directory
Tax ID family
University Psychological Centerinc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Practitioners & affiliated clinicians

Practitioners 1

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": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503619200000",
    "number": "1073030581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD STE U18",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402361",
            "telephone_number": "301-345-1919",
            "fax_number": "301-345-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015729",
            "telephone_number": "301-662-7003",
            "fax_number": "301-694-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PSYCHOLOGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "410-576-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 25, 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.