Active NPI
Mark Alan Hedlund, PHD
- Clinical Psychologist
- Annapolis, MD
National Provider Identifier
1366596280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2258
- Practice address
- 716 Giddings Ave Ste 33
Annapolis, MD 21401-1419 - Phone
- (443) 417-5117
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 2258 | MD | Primary |
Addresses
Primary practice location
716 Giddings Ave Ste 33
Annapolis, MD 21401-1419
Mailing address
716 Giddings Ave Ste 33
Annapolis, MD 21401-1419
Phone (443) 417-5117
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2258 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1366596280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 GIDDINGS AVE STE 33",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214011419",
"telephone_number": "443-417-5117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 GIDDINGS AVE STE 33",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214011419",
"telephone_number": "443-417-5117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDLUND",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "2258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.