Active NPI
Lee Ann Kingham, LCSW
- Family Psychologist
- Baltimore, MD
National Provider Identifier
1164086906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- 02909
- Practice address
- 4301 Roland Springs Drive
Baltimore, MD 21210 - Phone
- (443) 695-3539
- NPI assigned
- Apr 26, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | 02909 | MD | Primary |
Addresses
Primary practice location
4301 Roland Springs Drive
Baltimore, MD 21210
Mailing address
4301 Roland Springs Drive
Baltimore, MD 21210
Phone (443) 695-3539
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02909 | MD | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1164086906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 ROLAND SPRINGS DRIVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21210",
"telephone_number": "443-695-3539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 ROLAND SPRINGS DRIVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21210",
"telephone_number": "443-695-3539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGHAM",
"first_name": "LEE",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-26",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MD",
"license": "02909",
"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 Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.