Active NPI
Sulivette Nater-Hernandez, PSY.D.
- Clinical Psychologist
- Columbia, MD
National Provider Identifier
1639735806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810006186
- Practice address
- 6304 Woodside CT Ste 110G
Columbia, MD 21046-3217 - Phone
- (410) 855-4631
- NPI assigned
- May 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 0810006186 | VA | Primary |
Addresses
Primary practice location
6304 Woodside CT Ste 110G
Columbia, MD 21046-3217
Mailing address
6697 Huntshire Dr
Elkridge, MD 21075-6188
Phone (571) 282-5999
Other names 1
- Sulivette Hernandez Romero
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810006186 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Haven | Clinical | Current | Accepting new patients |
| Halcyon Clinical Services, LLC | Past | Accepting new patients |
Organizations & group practices 2
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 Social Worker
- Columbia, MD
- NPI 1821594482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1639735806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6697 HUNTSHIRE DR",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210756188",
"telephone_number": "571-282-5999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6304 WOODSIDE CT STE 110G",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210463217",
"telephone_number": "410-855-4631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATER-HERNANDEZ",
"first_name": "SULIVETTE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-14",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810006186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SULIVETTE",
"last_name": "HERNANDEZ ROMERO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Columbia, MD
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- Natasha Sandy MD PA
- O'Neil Nation Jr.
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- Javzandulam Natsag, M.D., PHD
- Natural Speech
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.