Active NPI
Jo Ann Mackinson, PSYCHOLOGIST
- Clinical Psychologist
- Ellicott City, MD
National Provider Identifier
1356996334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03455
- Practice address
- 8169 Old Montgomery Rd
Ellicott City, MD 21043-7940 - Phone
- (410) 696-7449
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 03455 | MD | Primary |
Addresses
Primary practice location
8169 Old Montgomery Rd
Ellicott City, MD 21043-7940
Mailing address
8169 Old Montgomery Rd
Ellicott City, MD 21043-7940
Phone (410) 696-7449
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1356996334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8169 OLD MONTGOMERY RD",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210437940",
"telephone_number": "410-696-7449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8169 OLD MONTGOMERY RD",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210437940",
"telephone_number": "410-696-7449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKINSON",
"first_name": "JO ANN",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "03455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.