NPIMap

Organization Active NPI

Psychology Consultants Assoc

  • Clinical Psychologist
  • Lutherville, MD
National Provider Identifier
1336354349
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00457 Issued in MD
Legal business name
PSYCHOLOGY CONSULTANTS ASSOC
Practice address
1205 York Rd
Lutherville, MD 21093-6210
Phone
(410) 998-3920
Fax
(410) 998-3931
NPI assigned
May 12, 2007
Last updated
Dec 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Louise Macy
Title
Billing MGR
Phone
(410) 998-3920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00457 MD Primary

Addresses

Primary practice location

1205 York Rd
Lutherville, MD 21093-6210

Mailing address

11421 Cronhill Dr
Owings Mills, MD 21117-2222
Phone (410) 998-3920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131211000807 MD Part B Supplier - Clinic/Group Practice 6507093960 Receives reassigned benefits from 3 practitioners
Practice locations: Timonium, MD

National Provider Directory

National Provider Directory

Locations

11421 Cronhill Dr
Owings Mills, MD 21117

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1336354349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11421 CRONHILL DR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172222",
            "telephone_number": "410-998-3920",
            "fax_number": "410-998-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-998-3920",
            "fax_number": "410-998-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY CONSULTANTS ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-12",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "410-998-3920"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "00457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.