Active NPI
Malinda Renee Kidd, PSY.D.
- Clinical Psychologist
- Clinton, MD
National Provider Identifier
1497091102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05186
- Practice address
- 9412 Fox Run Dr
Clinton, MD 20735-3049 - Phone
- (301) 275-6737
- NPI assigned
- Dec 27, 2012
- Sex
- Female
- 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 | 05186 | MD | Primary |
Addresses
Primary practice location
9412 Fox Run Dr
Clinton, MD 20735-3049
Mailing address
9412 Fox Run Dr
Clinton, MD 20735-3049
Phone (301) 275-6737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061225100 | Medicaid | MD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05186 | MD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Insideout Psychological Services, LLC | Clinical | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Psychologist
- Clinton, MD
- NPI 1821462557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1497091102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9412 FOX RUN DR",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353049",
"telephone_number": "301-275-6737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9412 FOX RUN DR",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353049",
"telephone_number": "301-275-6737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "MALINDA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-27",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05186",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061225100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.