NPIMap

Organization Active NPI

Stefanie Moynihan, PH.D., LLC

  • Clinical Psychologist
  • Annapolis, MD
National Provider Identifier
1285313015
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STEFANIE MOYNIHAN, PH.D., LLC
Practice address
220 Bowen CT Ste a
Annapolis, MD 21401-1945
Phone
(617) 302-6086
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Dr. Stefanie Alison Moynihan Kydes, PH.D.NPI 1235807512
Title
Clinical Psychologist
Phone
(617) 302-6086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

220 Bowen CT Ste a
Annapolis, MD 21401-1945

Mailing address

220 Bowen CT Ste a
Annapolis, MD 21401-1945

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1285313015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BOWEN CT STE A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BOWEN CT STE A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011945",
            "telephone_number": "617-302-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFANIE MOYNIHAN, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "KYDES",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_middle_name": "ALISON MOYNIHAN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "617-302-6086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.