Active NPI
Christine Lynne Martin, PH.D
- Psychologist
- Nottingham, MD
National Provider Identifier
1396865168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05509
- Practice address
- 9649 Belair Rd Ste 104
Nottingham, MD 21236-1117 - Phone
- (410) 529-1309
- Fax
- (410) 529-1005
- NPI assigned
- Mar 29, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18834 | CA | |
| Psychologist | 103T00000X | 05509 | MD | Primary |
Addresses
Primary practice location
9649 Belair Rd Ste 104
Nottingham, MD 21236-1117
Mailing address
9649 Belair Rd Ste 104
Nottingham, MD 21236-1117
Phone (410) 529-1309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY18834 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1910 Towne Centre Blvd
Suite 250
Annapolis, MD 21401-3599
Phone (866) 630-0966
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05509 | MD | MD | Psychologist |
| PSY18834 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
1910 Towne Centre Blvd
Ste 250
Annapolis, MD 21401
Phone (202) 596-8891
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1396865168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9649 BELAIR RD STE 104",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212361117",
"telephone_number": "410-529-1309",
"fax_number": "410-529-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9649 BELAIR RD STE 104",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212361117",
"telephone_number": "410-529-1309",
"fax_number": "410-529-1005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CHRISTINE",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18834",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PSY18834",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nottingham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.