Individual provider Active NPI

Mary-Jane Ebere Ojie-Badger, PHD

  • Clinical Psychologist
  • Ellicott City, MD
National Provider Identifier
1104133081
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05742 Issued in MD
Practice address
3355 Saint Johns LN Ste J
Ellicott City, MD 21042-2600
Phone
(410) 324-3883
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021387 NY
Clinical Psychologist 103TC0700X 05742 MD Primary

Addresses

Primary practice location

3355 Saint Johns LN Ste J
Ellicott City, MD 21042-2600

Mailing address

3355 Saint Johns LN Ste J
Ellicott City, MD 21042-2600
Phone (410) 324-3883

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
I20181017002302 MD Practitioner - Clinical Psychologist 3173825874 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05742MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ima Therapy Center LLC Clinical CurrentSince Dec 13, 2023 Accepting new patients

Locations

3355 Saint Johns Ln
Ste J
Ellicott City, MD 21042
Phone (410) 324-3883

3355 Saint Johns Ln
Ste F
Ellicott City, MD 21042
Phone (410) 775-6270

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1104133081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN STE J",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "410-324-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN STE J",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "410-324-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJIE-BADGER",
        "first_name": "MARY-JANE",
        "middle_name": "EBERE",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021387",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.