Active NPI
Ruth Stine, PSYD
- Psychologist
- Towson, MD
National Provider Identifier
1073555355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 04266
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.