Individual provider Active NPI

Michael Jasnow, PH.D

  • Clinical Psychologist
  • Cabin John, MD
National Provider Identifier
1558724872
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
01942 Issued in MD
Practice address
6500 Seven Locks Rd
#220
Cabin John, MD 20818-1300
Phone
(301) 263-1161
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 01942 MD Primary

Addresses

Primary practice location

6500 Seven Locks Rd
#220
Cabin John, MD 20818-1300

Mailing address

6500 Seven Locks Rd
#220
Cabin John, MD 20818-1300
Phone (301) 263-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2015 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
01942MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1558724872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 SEVEN LOCKS RD",
            "address_2": "#220",
            "city": "CABIN JOHN",
            "state": "MD",
            "postal_code": "208181300",
            "telephone_number": "301-263-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 SEVEN LOCKS RD",
            "address_2": "#220",
            "city": "CABIN JOHN",
            "state": "MD",
            "postal_code": "208181300",
            "telephone_number": "301-263-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASNOW",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "01942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabin John, MD

Sources for this page

Verify at the official NPI Registry.