Active NPI
Amy Rabinove-Leisawitz, PH.D.
- Psychologist
- Columbia, MD
National Provider Identifier
1295971414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 04524
- Practice address
- 8640 Guilford Rd
Suite 224
Columbia, MD 21046-2655 - Phone
- (443) 472-1198
- NPI assigned
- Dec 17, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 04524 | MD | Primary |
Addresses
Primary practice location
8640 Guilford Rd
Suite 224
Columbia, MD 21046-2655
Mailing address
8640 Guilford Road
Suite 224
Columbia, MD 21046
Phone (443) 472-1198
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090709000628 | MD | Practitioner - Clinical Psychologist | 7012069792 | Practice locations: Ellicott City, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5438 Autumn Field Court
Ellicott City, MD 21043-7083
5438 Autumn Field CT
Ellicott City, MD 21043-7083
Phone (443) 472-1198
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04524 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383004800000",
"number": "1295971414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8640 GUILFORD ROAD",
"address_2": "SUITE 224",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "21046",
"telephone_number": "443-472-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8640 GUILFORD RD",
"address_2": "SUITE 224",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210462655",
"telephone_number": "443-472-1198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABINOVE-LEISAWITZ",
"first_name": "AMY",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-17",
"last_updated": "2013-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "04524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.