Active NPI
Matthew J Yates, PSYD
- Clinical Psychologist
- Cumberland, MD
National Provider Identifier
1417412909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 06124
- Practice address
- 200 Glenn St
Cumberland, MD 21502-2573 - Phone
- (304) 263-0811
- Fax
- (301) 724-0069
- NPI assigned
- Feb 8, 2019
- 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 | 06124 | MD | Primary |
Addresses
Primary practice location
200 Glenn St
Cumberland, MD 21502-2573
Mailing address
14509 Cooper Rd
Phoenix, MD 21131-1305
Phone (410) 598-0805
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549584000000",
"number": "1417412909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14509 COOPER RD",
"city": "PHOENIX",
"state": "MD",
"postal_code": "211311305",
"telephone_number": "410-598-0805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 GLENN ST",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215022573",
"telephone_number": "304-263-0811",
"fax_number": "301-724-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "MATTHEW",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-08",
"last_updated": "2019-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "06124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumberland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.