Active NPI
Teresa Trabue, PSY.D.
- Clinical Psychologist
- Largo, MD
National Provider Identifier
1346471984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03025
- Practice address
- 1300 Mercantile LN
Largo, MD 20774-5327 - Phone
- (301) 322-3400
- Fax
- (301) 322-6050
- NPI assigned
- Jul 30, 2009
- Last updated
- Jul 30, 2009
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 03025 | MD | |
| Clinical Psychologist | 103TC0700X | 03025 | MD | Primary |
| Counseling Psychologist | 103TC1900X | 03025 | MD | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 03025 | MD | |
| Group Psychotherapy Psychologist | 103TP2701X | 03025 | MD | |
| School Psychologist | 103TS0200X | 03025 | MD |
Addresses
Primary practice location
1300 Mercantile LN
Largo, MD 20774-5327
Mailing address
1300 Mercantile LN
Largo, MD 20774-5327
Phone (301) 322-3400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 16, 2025 through May 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03025 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1346471984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 MERCANTILE LN",
"city": "LARGO",
"state": "MD",
"postal_code": "207745327",
"telephone_number": "301-322-3400",
"fax_number": "301-322-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 MERCANTILE LN",
"city": "LARGO",
"state": "MD",
"postal_code": "207745327",
"telephone_number": "301-322-3400",
"fax_number": "301-322-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRABUE",
"first_name": "TERESA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-30",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MD",
"license": "03025",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "03025",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MD",
"license": "03025",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "MD",
"license": "03025",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "MD",
"license": "03025",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MD",
"license": "03025",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.