Individual provider Active NPI

Cassandra Herbert, APRN/PMH-BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Ellicott City, MD
National Provider Identifier
1356630024
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
R148305 Issued in MD
Practice address
5026 Dorsey Hall Dr
Suite 205
Ellicott City, MD 21042-7852
Phone
(410) 415-1454
NPI assigned
Apr 4, 2011
Last updated
Dec 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R148305 MD Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X R148305 MD

Addresses

Primary practice location

5026 Dorsey Hall Dr
Suite 205
Ellicott City, MD 21042-7852

Mailing address

3756 Angelton CT
Burtonsville, MD 20866-2059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
R148305MDMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1356630024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3756 ANGELTON CT",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208662059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 DORSEY HALL DR",
            "address_2": "SUITE 205",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427852",
            "telephone_number": "410-415-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "CASSANDRA",
        "credential": "APRN/PMH-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R148305",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "R148305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.