NPIMap

Organization Active NPI

University Psychological Center

  • Psychiatry Physician
  • Berwyn Heights, MD
National Provider Identifier
1154659423
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UNIVERSITY PSYCHOLOGICAL CENTER
Practice address
6201 Greenbelt Rd
Suite U-18
Berwyn Heights, MD 20740-2354
Phone
(301) 345-1919
Fax
(301) 345-5779
NPI assigned
Nov 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Dr. Clark J Hudak Jr., PH.D.
Title
Director/Owner
Phone
(410) 576-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6201 Greenbelt Rd
Suite U-18
Berwyn Heights, MD 20740-2354

Mailing address

6201 Greenbelt Rd
Suite U-18
Berwyn Heights, MD 20740-2354
Phone (301) 345-1919

Other identifiers 1

IdentifierTypeStateIssuer
094981709MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Univ Psychological Ctr Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1154659423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD",
            "address_2": "SUITE U-18",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402354",
            "telephone_number": "301-345-1919",
            "fax_number": "301-345-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD",
            "address_2": "SUITE U-18",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402354",
            "telephone_number": "301-345-1919",
            "fax_number": "301-345-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PSYCHOLOGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "410-576-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094981709",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.