Organization Active NPI

Dr Steve LLC Skill Tree

  • Clinical Psychologist
  • Hampstead, MD
National Provider Identifier
1417764481
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR STEVE LLC SKILL TREE
Practice address
1216 N Main St FRNT
Hampstead, MD 21074-2256
Phone
(443) 900-3999
NPI assigned
Dec 13, 2024
Last updated
Dec 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Tasha Lynn Della Vecchia
Title
Program Coordinator
Phone
(443) 677-1639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1216 N Main St FRNT
Hampstead, MD 21074-2256

Mailing address

4272 Buckskin TRL
Hampstead, MD 21074-3102
Phone (443) 677-1639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123000226 MD Part B Supplier - Clinic/Group Practice 0345779104 Receives reassigned benefits from 1 practitioner
Practice locations: Hampstead, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1417764481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4272 BUCKSKIN TRL",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743102",
            "telephone_number": "443-677-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 N MAIN ST FRNT",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210742256",
            "telephone_number": "443-900-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR STEVE LLC SKILL TREE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "DELLA VECCHIA",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "443-677-1639"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.