Individual provider Active NPI

Danielle Raines, PSY.D.

  • Clinical Neuropsychologist
  • Baltimore, MD
National Provider Identifier
1669894200
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
05267 Issued in MD
Practice address
1708 W Rogers Ave
Baltimore, MD 21209-4545
Phone
(410) 578-5240
Fax
(410) 367-4197
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 05267 MD Primary

Addresses

Primary practice location

1708 W Rogers Ave
Baltimore, MD 21209-4545

Mailing address

1708 West Rogers Road
Baltimore, MD 21209
Phone (410) 578-5240

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
05267MDMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1669894200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 WEST ROGERS ROAD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21209",
            "telephone_number": "410-578-5240",
            "fax_number": "410-367-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094545",
            "telephone_number": "410-578-5240",
            "fax_number": "410-367-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINES",
        "first_name": "DANIELLE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "05267",
            "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 Jan 16, 2014; 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.