Active NPI
Make It Possible, LLC
- Clinical Psychologist
- Waldorf, MD
National Provider Identifier
1124888656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- MAKE IT POSSIBLE, LLC
- Practice address
- 2255 Crain Hwy
Suite 202
Waldorf, MD 20601 - Phone
- (757) 803-6399
- NPI assigned
- Mar 21, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amarilys Galloza Carrero, PH.D.
- Title
- Clinical Psychologist
- Phone
- (757) 803-6399
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
2255 Crain Hwy
Suite 202
Waldorf, MD 20601
Mailing address
440 Monticello Ave Ste 1802
PMB 936995
Norfolk, VA 23510-2670
Phone (757) 803-6399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710979200000",
"number": "1124888656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 MONTICELLO AVE STE 1802",
"address_2": "PMB 936995",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235102670",
"telephone_number": "757-803-6399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 CRAIN HWY",
"address_2": "SUITE 202",
"city": "WALDORF",
"state": "MD",
"postal_code": "20601",
"telephone_number": "757-803-6399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAKE IT POSSIBLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-21",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A",
"authorized_official_last_name": "GALLOZA CARRERO",
"authorized_official_first_name": "AMARILYS",
"authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
"authorized_official_telephone_number": "757-803-6399",
"authorized_official_credential": "PH.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.