Individual provider Active NPI

Chandler McLemore

  • Clinical Psychologist
  • Severna Park, MD
National Provider Identifier
1669822797
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06112 Issued in MD
Practice address
877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716
Phone
(410) 684-3806
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 06112 MD Primary

Addresses

Primary practice location

877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716

Mailing address

877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716
Phone (410) 684-3806

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
06112MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1669822797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 BALTIMORE ANNAPOLIS BLVD STE 202",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464716",
            "telephone_number": "410-684-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 BALTIMORE ANNAPOLIS BLVD STE 202",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464716",
            "telephone_number": "410-684-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "CHANDLER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.