Active NPI
Anne Marie Middaugh, PH.D.
- Clinical Psychologist
- Catonsville, MD
National Provider Identifier
1366525784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04548
- Practice address
- 4 W Rolling Crossroads
Ste 3
Catonsville, MD 21228-6280 - Phone
- (443) 866-0912
- Fax
- (410) 455-5288
- NPI assigned
- Oct 21, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3258 | AZ | |
| Clinical Psychologist | 103TC0700X | 04548 | MD | Primary |
Addresses
Primary practice location
4 W Rolling Crossroads
Ste 3
Catonsville, MD 21228-6280
Mailing address
4 W Rolling Crossroads
Ste 3
Catonsville, MD 21228-6280
Phone (443) 866-0912
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 419430600 | Medicaid | MD |
Other names 1
- Anne Marie Wideman
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3258 | AZ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanya N Bryant LCSW-C | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Catonsville, MD
- NPI 1033664099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1366525784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 W ROLLING CROSSROADS",
"address_2": "STE 3",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212286280",
"telephone_number": "443-866-0912",
"fax_number": "410-455-5288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 W ROLLING CROSSROADS",
"address_2": "STE 3",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212286280",
"telephone_number": "443-866-0912",
"fax_number": "410-455-5288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDAUGH",
"first_name": "ANNE",
"middle_name": "MARIE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-21",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3258",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04548",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "419430600",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNE",
"last_name": "WIDEMAN",
"middle_name": "MARIE",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Catonsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.