Active NPI
Yan Ni, PSYD
- Clinical Psychologist
- Gaithersburg, MD
National Provider Identifier
1275260564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 06217
- Practice address
- 656 Quince Orchard Rd Ste 600
Gaithersburg, MD 20878-1418 - Phone
- (484) 885-6618
- NPI assigned
- Aug 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 06217 | MD | Primary |
Addresses
Primary practice location
656 Quince Orchard Rd Ste 600
Gaithersburg, MD 20878-1418
Mailing address
7404 Willow View LN
Glen Burnie, MD 21060-8649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 27, 2019 through Nov 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06217 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1275260564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7404 WILLOW VIEW LN",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210608649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "656 QUINCE ORCHARD RD STE 600",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208781418",
"telephone_number": "484-885-6618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NI",
"first_name": "YAN",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-05",
"last_updated": "2022-08-05",
"certification_date": "2022-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "06217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.