NPIMap

Individual provider Active NPI

Lauren Bynum

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1457530438
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8785 Issued in MA
Practice address
4502 Schenley Rd # 100a
Baltimore, MD 21210-2524
Phone
(443) 440-6125
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8785 MA Primary

Addresses

Primary practice location

4502 Schenley Rd # 100a
Baltimore, MD 21210-2524

Mailing address

4502 Schenley Rd # 100a
Baltimore, MD 21210-2524
Phone (443) 440-6125

Other practice location 1

5113 Falls Road Ter
Baltimore, MD 21210-1921
Phone (773) 301-3730

Other practice location 2

540 E Belvedere Ave Ste 203
Baltimore, MD 21212
Phone (443) 926-9115

Other names 1

  • Lauren Gaskill Former name

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8785MAMDPsychologist
05089MDMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Sky Therapy Services, LLC Past Accepting new patients
Authentic Spaces Counseling, LLC Past Accepting new patients

Organizations & group practices 2

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1457530438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 SCHENLEY RD # 100A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102524",
            "telephone_number": "443-440-6125",
            "fax_number": "443-440-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 SCHENLEY RD # 100A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102524",
            "telephone_number": "443-440-6125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5113 Falls Road Ter",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212101921",
            "country_code": "US",
            "telephone_number": "773-301-3730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 E Belvedere Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21212",
            "country_code": "US",
            "telephone_number": "443-926-9115",
            "fax_number": "443-926-9116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "GASKILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 25, 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.

Verify at the official NPI Registry.