Active NPI
Edwin C Oliver, PSY D
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1124039268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3777
- Practice address
- 2220 Saint Paul St
Baltimore, MD 21218-5805 - Phone
- (410) 261-5500
- Fax
- (410) 366-7680
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3777 | MD | Primary |
Addresses
Primary practice location
2220 Saint Paul St
Baltimore, MD 21218-5805
Mailing address
3300 North Ridge Road
Suite 110
Ellicott City, MD 21043
Phone (410) 561-9584
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3777 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan Metro Maryland Counseling Ctr | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Timonium, MD
- NPI 1194937466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124039268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 NORTH RIDGE ROAD",
"address_2": "SUITE 110",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "21043",
"telephone_number": "410-561-9584",
"fax_number": "410-750-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 SAINT PAUL ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212185805",
"telephone_number": "410-261-5500",
"fax_number": "410-366-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "EDWIN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "3777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.