Individual provider Active NPI

Christine Lynne Martin, PH.D

  • Psychologist
  • Nottingham, MD
National Provider Identifier
1396865168
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05509 Issued in MD
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

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PSY18834OtherCALICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023001006 MD Practitioner - Clinical Psychologist 1153510912 Reassigns benefits to 1 organization

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
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

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

LicenseStateTypeSpecialty
05509MDMDPsychologist
PSY18834CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jan 9, 2025 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

Verify at the official NPI Registry.