Individual provider Active NPI

Rebecca MJ Brown, PSYD

  • Psychologist
  • Glen Burnie, MD
National Provider Identifier
1649893033
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
6720G Ritchie Hwy # 250
Glen Burnie, MD 21061-2319
Phone
(818) 497-6703
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY200001268 DC
Nutritionist 133N00000X
Health & Wellness Coach 171400000X
Naturopath 175F00000X
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X Primary

Addresses

Primary practice location

6720G Ritchie Hwy # 250
Glen Burnie, MD 21061-2319

Mailing address

6720G Ritchie Hwy # 250
Glen Burnie, MD 21061-2319
Phone (818) 497-6703

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

State licenses

LicenseStateTypeSpecialty
PSY200001268DCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunstone Clinical CurrentSince Jan 21, 2024 Accepting new patients

Locations

6720 Ritchie Hwy
Ste G
Glen Burnie, MD 21061
Phone (301) 744-7742

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1649893033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720G RITCHIE HWY # 250",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612319",
            "telephone_number": "818-497-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720G RITCHIE HWY # 250",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612319",
            "telephone_number": "818-497-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REBECCA",
        "middle_name": "MJ",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY200001268",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.