Organization Active NPI

Middleton Psychology Services, LLC

  • Clinical Psychologist
  • Frederick, MD
National Provider Identifier
1134579626
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MIDDLETON PSYCHOLOGY SERVICES, LLC
Practice address
186 Thomas Johnson Dr Ste 204
Frederick, MD 21702-4478
Phone
(301) 360-5859
NPI assigned
Jun 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Carl Middleton, PH.D.NPI 1255436671
Title
Chief Executive Officer
Phone
(301) 360-5859

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)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

186 Thomas Johnson Dr Ste 204
Frederick, MD 21702-4478

Mailing address

186 Thomas Johnson Drive
Suite 204
Frederick, MD 21702
Phone (301) 360-5859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220505002254 MD Part B Supplier - Clinic/Group Practice 3274910575 Receives reassigned benefits from 3 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

186 Thomas Johnson Dr
Ste 204
Frederick, MD 21702
Phone (240) 210-9003

Practitioners & affiliated clinicians

Practitioners 4

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": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1134579626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 THOMAS JOHNSON DRIVE",
            "address_2": "SUITE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21702",
            "telephone_number": "301-360-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 THOMAS JOHNSON DR STE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024478",
            "telephone_number": "301-360-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETON PSYCHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-360-5859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.