Individual provider Active NPI

Si Si Han, PHD, ABPP

  • Clinical Psychologist
  • Ellicott City, MD
National Provider Identifier
1104305218
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06921 Issued in MD
Practice address
3300 N Ridge Rd Ste 230
Ellicott City, MD 21043-3387
Phone
(410) 988-2192
Fax
(410) 988-2927
NPI assigned
Aug 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 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 06921 MD Primary
Clinical Psychologist 103TC0700X 0810006276 VA

Addresses

Primary practice location

3300 N Ridge Rd Ste 230
Ellicott City, MD 21043-3387

Mailing address

3300 N Ridge Rd Ste 230
Ellicott City, MD 21043-3387
Phone (410) 988-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200903002003 VA Practitioner - Clinical Psychologist 5799102869 Reassigns benefits to 1 organization
I20230630000062 MD Practitioner - Clinical Psychologist 5799102869 Reassigns benefits to 1 organization
I20230906001036 DC Practitioner - Clinical Psychologist 5799102869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3300 N Ridge Rd
Suite 230
Ellicott City, MD 21043-3387
Phone (410) 988-2192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810006276VAMDClinical Psychologist
06921MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Winchester Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Chinese Culture and Community Service Center, Inc. CurrentSince Jul 19, 2023 Accepting new patients
Winchester Medical Center Current Accepting new patients
Chinese Culture and Community Service Center, Inc. CurrentSince Jul 19, 2023 Accepting new patients
Brain & Behavior Care LLC CurrentSince Jun 1, 2023 Accepting new patients
Chinese Culture and Community Services Center, Inc. Past Accepting new patients

Locations

3300 North Ridge Rd
Ste 230
Ellicott City, MD 21043
Phone (410) 750-3330

3290 North Ridge Rd
Ste 260
Ellicott City, MD 21043
Phone (410) 988-2192

9366 Gaither Rd
Rm 156A
Gaithersburg, MD 20877

9318 Gaither Rd
Ste 205
Gaithersburg, MD 20877
Phone (240) 393-5950

9298 Gaither Rd
Gaithersburg, MD 20877
Phone (240) 393-5950

220 Campus Blvd
Ste 100
Winchester, VA 22601

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Organizations & group practices 7

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": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1104305218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N RIDGE RD STE 230",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433387",
            "telephone_number": "410-988-2192",
            "fax_number": "410-988-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N RIDGE RD STE 230",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433387",
            "telephone_number": "410-988-2192",
            "fax_number": "410-988-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "SI SI",
        "credential": "PHD, ABPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06921",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.