Individual provider Active NPI

Joann K. Thacker, PHD

  • Psychologist
  • Silver Spring, MD
National Provider Identifier
1205862406
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01659 Issued in MD
Practice address
11215 Oak Leaf Dr
Suite 108
Silver Spring, MD 20901-1317
Phone
(301) 593-1315
Fax
(301) 681-4699
NPI assigned
Jun 23, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01659 MD Primary

Addresses

Primary practice location

11215 Oak Leaf Dr
Suite 108
Silver Spring, MD 20901-1317

Mailing address

11215 Oak Leaf Dr
Suite 108
Silver Spring, MD 20901-1317
Phone (301) 593-1315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111110000173 DC Practitioner - Clinical Psychologist 0345414231 Reassigns benefits to 1 organization
I20150422001457 MD Practitioner - Clinical Psychologist 0345414231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

11215 Oak Leaf Dr
Suite 109
Silver Spring, MD 20901-1300
Phone (301) 593-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
01659MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC Psychologist CurrentSince Mar 23, 1999 Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205862406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 OAK LEAF DR",
            "address_2": "SUITE 108",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011317",
            "telephone_number": "301-593-1315",
            "fax_number": "301-681-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 OAK LEAF DR",
            "address_2": "SUITE 108",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011317",
            "telephone_number": "301-593-1315",
            "fax_number": "301-681-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "JOANN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.