Individual provider Active NPI

Jamie T Carreno Davidson, PHD

  • Psychologist
  • Bethesda, MD
National Provider Identifier
1154614345
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1729 Issued in AL
Practice address
4301 Jones Bridge Rd
Bethesda, MD 20814-4712
Phone
(301) 295-3271
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1729 AL Primary
Psychologist 103T00000X

Addresses

Primary practice location

4301 Jones Bridge Rd
Bethesda, MD 20814-4712

Mailing address

2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Phone (301) 677-8895

Other names 1

  • Dr. Jaime T Carreno Professional name

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1729ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1154614345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144712",
            "telephone_number": "301-295-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRENO DAVIDSON",
        "first_name": "JAMIE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "1729",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "CARRENO",
            "middle_name": "T",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bethesda, MD

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.