Individual provider Active NPI

Charles Michael Citrenbaum, PH.D.

  • Health Service Psychologist
  • Baltimore, MD
National Provider Identifier
1639297682
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
897 Issued in MD
Practice address
2 Hamill Rd.
Suite 322
Baltimore, MD 21210-1813
Phone
(410) 433-6555
Fax
(410) 433-6565
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 897 MD
Addiction (Substance Use Disorder) Psychologist 103TA0400X 897 MD
Clinical Psychologist 103TC0700X 897 MD
Clinical Child & Adolescent Psychologist 103TC2200X 897 MD
Exercise & Sports Psychologist 103TE1100X 897 MD
Family Psychologist 103TF0000X 897 MD
Forensic Psychologist 103TF0200X 897 MD
Health Service Psychologist 103TH0100X 897 MD Primary

Addresses

Primary practice location

2 Hamill Rd.
Suite 322
Baltimore, MD 21210-1813

Mailing address

2 Hamill Rd.
Suite 322
Baltimore, MD 21210-1813
Phone (410) 433-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090304000490 MD Practitioner - Clinical Psychologist 6901962687 Practice locations: Owings Mills, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9199 Reisterstown Rd
Suite 216C
Owings Mills, MD 21117-4577
Phone (410) 363-4428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639297682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HAMILL RD.",
            "address_2": "SUITE 322",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101813",
            "telephone_number": "410-433-6555",
            "fax_number": "410-433-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HAMILL RD.",
            "address_2": "SUITE 322",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101813",
            "telephone_number": "410-433-6555",
            "fax_number": "410-433-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRENBAUM",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MD",
            "license": "897",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MD",
            "license": "897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.