Holly M Chalk, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

04635 Issued in MD

Practice address

1425 Liberty Rd
Suite 208
Eldersburg, MD 21784-6420

Phone

(410) 552-0773

Fax

(410) 552-0774

NPI assigned

Jan 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cedar Ridge Counseling Centers, LLCGroup PAC ID 4981649738, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cedar Ridge Counseling Centers LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eldersburg, MD
  • NPI 1932103926
  Medicare reassignment Care Compare group NPD
• Balanced Resilience Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Eldersburg, MD
  • NPI 1669337226
  NPD (past)

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1174853253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 LIBERTY RD",
            "address_2": "SUITE 208",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846420",
            "telephone_number": "410-552-0773",
            "fax_number": "410-552-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 LIBERTY RD",
            "address_2": "SUITE 208",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846420",
            "telephone_number": "410-552-0773",
            "fax_number": "410-552-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALK",
        "first_name": "HOLLY",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Eldersburg, MD
• Providers in Eldersburg, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.