Individual provider Active NPI

Charlotte L. Callens, M.A. PH.D. M.SC.

  • Psychologist
  • Annapolis, MD
National Provider Identifier
1437310745
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01211 Issued in MD
Practice address
104 Forbes Street,
Suite 205
Annapolis, MD 21401
Phone
(443) 624-4048
Fax
(410) 266-3929
NPI assigned
Jun 19, 2008
Last updated
Mar 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01211 MD Primary

Addresses

Primary practice location

104 Forbes Street,
Suite 205
Annapolis, MD 21401

Mailing address

104 Forbes Street,
Suite 205
Annapolis, MD 21401
Phone (443) 624-4048

Other identifiers 1

IdentifierTypeStateIssuer
404112700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
01211MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Callens, LLC CurrentSince Jul 1, 2009 Accepting new patients

Locations

104 Forbes St
Ste 205
Annapolis, MD 21401
Phone (443) 624-4048

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1437310745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FORBES STREET,",
            "address_2": "SUITE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "443-624-4048",
            "fax_number": "410-266-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FORBES STREET,",
            "address_2": "SUITE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "443-624-4048",
            "fax_number": "410-266-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLENS",
        "first_name": "CHARLOTTE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.A. PH.D. M.SC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404112700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.