Individual provider Active NPI

Michael A Marquez, PSY.D.

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1699327221
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
06304 Issued in MD
Practice address
156 N Lakewood Ave
Baltimore, MD 21224-1143
Phone
(443) 478-3453
NPI assigned
Jul 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 06304 MD Primary

Addresses

Primary practice location

156 N Lakewood Ave
Baltimore, MD 21224-1143

Mailing address

156 N Lakewood Ave
Baltimore, MD 21224-1143
Phone (443) 478-3453

Other practice location 1

846 W 36th St Ste 2
Baltimore, MD 21211-2561
Phone (443) 478-3453

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
06304MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1562976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1699327221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 N LAKEWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241143",
            "telephone_number": "443-478-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 N LAKEWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241143",
            "telephone_number": "443-478-3453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "846 W 36th St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212112561",
            "country_code": "US",
            "telephone_number": "443-478-3453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-13",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "06304",
            "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 Dec 4, 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.