NPIMap

Individual provider Active NPI

Daniel P Evatt, PH.D.

  • Clinical Psychologist
  • Eldersburg, MD
National Provider Identifier
1073894838
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04857 Issued in MD
Practice address
1311 Londontown Blvd
Suite 130a
Eldersburg, MD 21784-6454
Phone
(410) 552-0773
Fax
(410) 549-3197
NPI assigned
Sep 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04857 MD Primary

Addresses

Primary practice location

1311 Londontown Blvd
Suite 130a
Eldersburg, MD 21784-6454

Mailing address

PO Box 1229
Sykesville, MD 21784-1229
Phone (410) 549-3196

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Resilience Mental Health PastSince Dec 21, 2025 Accepting new patients
Cedar Ridge Counseling Centers LLC PastSince May 3, 2011 Accepting new patients

Organizations & group practices 2

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": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1073894838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1229",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217841229",
            "telephone_number": "410-549-3196",
            "fax_number": "410-549-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 LONDONTOWN BLVD",
            "address_2": "SUITE 130A",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846454",
            "telephone_number": "410-552-0773",
            "fax_number": "410-549-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVATT",
        "first_name": "DANIEL",
        "middle_name": "P",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.