NPIMap

Organization Active NPI

Fetherson & Knight Psychological Services, LLC

  • Adult Mental Health Clinic/Center
  • Lanham, MD
National Provider Identifier
1558828996
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
FETHERSON & KNIGHT PSYCHOLOGICAL SERVICES, LLC
Practice address
7404 Executive PL Ste 225B
Lanham, MD 20706-6205
Phone
(240) 929-4387
Fax
(240) 929-4391
NPI assigned
Feb 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Authorized official

Name
Dr. Bianca Fetherson, PH.D.NPI 1003154691
Title
Clinical Director/Co-Owner
Phone
(240) 929-4387

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

7404 Executive PL Ste 225B
Lanham, MD 20706-6205

Mailing address

7404 Executive PL Ste 225B
Lanham, MD 20706-6205
Phone (240) 929-4387

National Provider Directory

National Provider Directory

Locations

7404 Executive Pl
Ste 225B
Lanham, MD 20706
Phone (240) 929-4387

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568419200000",
    "number": "1558828996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL STE 225B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066205",
            "telephone_number": "240-929-4387",
            "fax_number": "240-929-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL STE 225B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066205",
            "telephone_number": "240-929-4387",
            "fax_number": "240-929-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FETHERSON & KNIGHT PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-09-14",
        "status": "A",
        "authorized_official_last_name": "FETHERSON",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/CO-OWNER",
        "authorized_official_telephone_number": "240-929-4387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.