NPIMap

Organization Active NPI

Xisto Psychology LLC

  • Clinical Psychologist
  • Laurel, MD
National Provider Identifier
1669241832
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
XISTO PSYCHOLOGY LLC
Practice address
14415 Cannock Chase
Laurel, MD 20707
Phone
(410) 777-5709
NPI assigned
Dec 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Andrea XistoNPI 1740900208
Title
Managing Psychologist and Founder
Phone
(410) 777-5709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

14415 Cannock Chase
Laurel, MD 20707

Mailing address

14280 Baltimore Ave # 1175
Laurel, MD 20707-5006

National Provider Directory

National Provider Directory

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": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1669241832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14280 BALTIMORE AVE # 1175",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14415 CANNOCK CHASE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "410-777-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XISTO PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "XISTO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MANAGING PSYCHOLOGIST AND FOUNDER",
        "authorized_official_telephone_number": "410-777-5709"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.