Active NPI
Jessica Lynn David, PHD
- Counseling Psychologist
- Baltimore, MD
National Provider Identifier
1639899545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 06638
- Practice address
- 33 N Potomac St
Baltimore, MD 21224-1336 - Phone
- (804) 301-2477
- NPI assigned
- Aug 31, 2022
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 06638 | MD | Primary |
Addresses
Primary practice location
33 N Potomac St
Baltimore, MD 21224-1336
Mailing address
310 Dunham CT
Severna Park, MD 21146-1670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06638 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1639899545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 DUNHAM CT",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211461670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 N POTOMAC ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212241336",
"telephone_number": "804-301-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-31",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MD",
"license": "06638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.