Magda Ellen Rodriguez Gonzalez, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05341 Issued in MD

Practice address

13 Annapolis Road
Suite 207
Odenton, MD 21113-1216

Phone

(410) 216-4992

NPI assigned

Feb 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Magda Ellen Gonzalez Nieves Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 16, 2015 through Mar 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Behavior Therapy Center of Greater Washington, P.a.

  • Cognitive & Behavioral Psychologist
  • Silver Spring, MD
  • NPI 1801005442
  NPD (past)

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1194140657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 WILD MUSTARD DRIVE",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211136041",
            "telephone_number": "301-593-4040",
            "fax_number": "301-593-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ANNAPOLIS ROAD",
            "address_2": "SUITE 207",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131216",
            "telephone_number": "410-216-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ GONZALEZ",
        "first_name": "MAGDA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGDA",
            "last_name": "GONZALEZ NIEVES",
            "middle_name": "ELLEN",
            "prefix": "MRS.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashleigh Roberts
• Deja Nichelle Robinson
• Robin Renay Robinson, AU.D.
• Shannon P Robinson, DPT
• Kennice Elisa Rodney, CRNP
• Carolina Jamileth Rodriguez
• Natalie Rodriguez
• Casey Noelle Roetz
• Cecilia Marie Roling, MS, OTR/L
• Meghan Rose Ronan

• Clinical Psychologist in Odenton, MD
• Providers in Odenton, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.