Organization Active NPI

Stephanie Durruthy,M.D.,PA

  • Adult Mental Health Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1578748737
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
D36443 Issued in MD
Legal business name
STEPHANIE DURRUTHY,M.D.,PA
Practice address
5074 Dorsey Hall Dr
Suite 105
Ellicott City, MD 21042-7792
Phone
(410) 992-0272
Fax
(410) 964-0048
NPI assigned
Jan 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Dr. Stephanie Susan Durruthy, M.D.
Title
Owner
Phone
(410) 992-0272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X D36443 MD Primary

Addresses

Primary practice location

5074 Dorsey Hall Dr
Suite 105
Ellicott City, MD 21042-7792

Mailing address

5074 Dorsey Hall Dr
Suite 105
Ellicott City, MD 21042-7792
Phone (410) 992-0272

National Provider Directory

National Provider Directory

Locations

5074 Dorsey Hall Dr
Ste 105
Ellicott City, MD 21042
Phone (410) 418-8837

Practitioners & affiliated clinicians

Practitioners 1

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": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1578748737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5074 DORSEY HALL DR",
            "address_2": "SUITE 105",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427792",
            "telephone_number": "410-992-0272",
            "fax_number": "410-964-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5074 DORSEY HALL DR",
            "address_2": "SUITE 105",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427792",
            "telephone_number": "410-992-0272",
            "fax_number": "410-964-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE DURRUTHY,M.D.,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "DURRUTHY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-992-0272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "D36443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.