NPIMap

Organization Active NPI

Lca Psychological Associates, LLC

  • Clinical Psychologist
  • Waldorf, MD
National Provider Identifier
1285953380
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LCA PSYCHOLOGICAL ASSOCIATES, LLC
Practice address
11315 Pembrooke SQ Ste 112a
Waldorf, MD 20603-4806
Phone
(850) 377-5389
NPI assigned
May 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Authorized official

Name
Dr. Lavonne A BrowneNPI 1598933764
Title
Practice Administrator
Phone
(850) 377-5389

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

11315 Pembrooke SQ Ste 112a
Waldorf, MD 20603-4806

Mailing address

PO Box 249
Olney, MD 20830-0249
Phone (850) 377-5389

Other names 1

  • Mackenzie Counseling and Consultation Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230313002115 MD Part B Supplier - Clinic/Group Practice 5294009973 Receives reassigned benefits from 6 practitioners
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Locations

11315 Pembrooke Sq
Ste 112A
Waldorf, MD 20603
Phone (301) 645-2233

Practitioners & affiliated clinicians

Practitioners 6

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": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1285953380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208300249",
            "telephone_number": "850-377-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 PEMBROOKE SQ STE 112A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034806",
            "telephone_number": "850-377-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCA PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "BROWNE",
        "authorized_official_first_name": "LAVONNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "850-377-5389",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mackenzie Counseling and Consultation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.