NPIMap

Individual provider Active NPI

Michael Wayne Nolet, PH.D.

  • Clinical Psychologist
  • Fort Meade, MD
National Provider Identifier
1326178724
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3990 Issued in MD
Practice address
2480 Llewellyn Ave Dept of
Fort Meade, MD 20755-7081
Phone
(301) 677-8895
NPI assigned
Mar 6, 2007
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3990 MD
Clinical Psychologist 103TC0700X 3990 MD Primary
Clinical Child & Adolescent Psychologist 103TC2200X 3990 MD
Group Psychotherapy Psychologist 103TP2701X 3990 MD

Addresses

Primary practice location

2480 Llewellyn Ave Dept of
Fort Meade, MD 20755-7081

Mailing address

2480 Llewellyn Ave Dept of
Fort Meade, MD 20755-7081
Phone (301) 677-8895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3990MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Psychological Associates, LLC Psychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1326178724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE DEPT OF",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE DEPT OF",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLET",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "3990",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "3990",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "3990",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "3990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.