NPIMap

Organization Active NPI

University Psychological Center, Inc

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1669923462
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH-1587 Issued in MD
Legal business name
UNIVERSITY PSYCHOLOGICAL CENTER, INC
Practice address
201 N Charles St
Suite 200
Baltimore, MD 21201-4102
Phone
(410) 576-9191
Fax
(410) 576-9257
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Dr. Clark J Hudak, PH.D.
Title
Preseident/Owner
Phone
(410) 576-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH-1587 MD Primary

Addresses

Primary practice location

201 N Charles St
Suite 200
Baltimore, MD 21201-4102

Mailing address

6201 Greenbelt Rd
Suite U-18
Berwyn Heights, MD 20740-2354
Phone (410) 576-9191

Other identifiers 1

IdentifierTypeStateIssuer
422057800MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Univ Psychological Ctr Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1669923462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD",
            "address_2": "SUITE U-18",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402354",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CHARLES ST",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014102",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PSYCHOLOGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESEIDENT/OWNER",
        "authorized_official_telephone_number": "410-576-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "MH-1587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422057800",
            "state": "MD"
        }
    ],
    "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 Oct 18, 2016; 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.