Individual provider Active NPI

Donna Michelle Beck

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1316439474
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04428 Issued in MD
Practice address
1301 Woodbourne Ave
Baltimore, MD 21239-3316
Phone
(410) 433-1000
NPI assigned
Jun 5, 2018
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04428 MD Primary

Addresses

Primary practice location

1301 Woodbourne Ave
Baltimore, MD 21239-3316

Mailing address

7811 Perry Rd
Nottingham, MD 21236-3922
Phone (443) 850-1978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 28, 2022 through Jun 28, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
04428MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1316439474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7811 PERRY RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212363922",
            "telephone_number": "443-850-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WOODBOURNE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212393316",
            "telephone_number": "410-433-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "DONNA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.