Ingrid Faviola Ponciano, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LCM637 Issued in MD

Practice address

13228 Executive Park Ter
Germantown, MD 20874-2640

Phone

(240) 489-1108

Fax

(240) 474-0068

NPI assigned

Jul 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Ingrid Faviola Cartagena Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 31, 2024 through Jan 31, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ponciano Counseling and Wellness, LLC

  dba Vertex Counseling and Wellness

  • Mental Health Counselor
  • Germantown, MD
  • NPI 1457828105
  NPD Authorized official

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1114230703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13228 EXECUTIVE PARK TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742640",
            "telephone_number": "240-489-1108",
            "fax_number": "240-474-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13228 EXECUTIVE PARK TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742640",
            "telephone_number": "240-489-1108",
            "fax_number": "240-474-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCIANO",
        "first_name": "INGRID",
        "middle_name": "FAVIOLA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INGRID",
            "last_name": "CARTAGENA",
            "middle_name": "FAVIOLA",
            "prefix": "MRS.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PM Pediatrics of Maryland LLC
• Clifford Poddar, PA-C
• Carrie Pollock, M.S., CCC-SLP
• Ponciano Counseling and Wellness, LLC (Vertex Counseling and Wellness)
• Stephany Alexandra Ponciano Guevara, LCPC
• Danielle Poole
• Anoopa Poovathodi, PHARMD
• Denise Popevis, LCPC
• Allcirys Julissa Porras Castillo
• Positive Recovery LLC

• Marriage & Family Therapist in Germantown, MD
• Providers in Germantown, MD by specialty
• Marriage & Family Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.