Individual provider Active NPI

Jaime M Fenton, PHD

  • Counseling Psychologist
  • Towson, MD
National Provider Identifier
1366891806
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
4435 Issued in MD
Practice address
312 W Chesapeake Ave
Second Floor
Towson, MD 21204-4410
Phone
(443) 602-6426
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4435 MD Primary

Addresses

Primary practice location

312 W Chesapeake Ave
Second Floor
Towson, MD 21204-4410

Mailing address

312 W Chesapeake Ave
Second Floor
Towson, MD 21204-4410
Phone (443) 602-6426

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4435MDMDCounseling Psychologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1366891806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W CHESAPEAKE AVE",
            "address_2": "SECOND FLOOR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044410",
            "telephone_number": "443-602-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W CHESAPEAKE AVE",
            "address_2": "SECOND FLOOR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044410",
            "telephone_number": "443-602-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "JAIME",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "4435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.