Individual provider Active NPI

Alicia Lucksted, PHD

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1437489192
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
03550 Issued in MD
Practice address
737 W Lombard St
5TH Floor
Baltimore, MD 21201-1009
Phone
(410) 706-3244
NPI assigned
Dec 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 03550 MD Primary

Addresses

Primary practice location

737 W Lombard St
5TH Floor
Baltimore, MD 21201-1009

Mailing address

737 West Lombard Street, RM 528
Umd Dept of Psychiatry, DSR, Ctr for MH SVCS Research
Baltimore, MD 21201
Phone (410) 706-3244

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03550MDMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1437489192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 WEST LOMBARD STREET, RM 528",
            "address_2": "UMD DEPT OF PSYCHIATRY, DSR, CTR FOR MH SVCS RESEARCH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-706-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 W LOMBARD ST",
            "address_2": "5TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011009",
            "telephone_number": "410-706-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKSTED",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "03550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.