Individual provider Active NPI

Ruth Stine, PSYD

  • Psychologist
  • Towson, MD
National Provider Identifier
1073555355
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
04266 Issued in MD
Practice address
1107 Kenilworth Dr
Suite 208
Towson, MD 21204-2140
Phone
(443) 536-2395
Fax
(410) 878-7433
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 04266 MD Primary

Addresses

Primary practice location

1107 Kenilworth Dr
Suite 208
Towson, MD 21204-2140

Mailing address

1107 Kenilworth Dr
Suite 208
Towson, MD 21204-2140
Phone (443) 536-2395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061017000148 MD Practitioner - Clinical Psychologist 7012913973 Practice locations: Towson, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
George Washington University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 Kenilworth Dr
Suite 208
Towson, MD 21204-2136
Phone (443) 536-2395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC Psychologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1073555355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 KENILWORTH DR",
            "address_2": "SUITE 208",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042140",
            "telephone_number": "443-536-2395",
            "fax_number": "410-878-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 KENILWORTH DR",
            "address_2": "SUITE 208",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042140",
            "telephone_number": "443-536-2395",
            "fax_number": "410-878-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.