Active NPI
Tracy Waldeck, PHD
- Clinical Psychologist
- Bethesda, MD
National Provider Identifier
1699628297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03679
- Practice address
- 4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558 - Phone
- (301) 704-7385
- NPI assigned
- Feb 16, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 03679 | MD | Primary |
Addresses
Primary practice location
4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558
Mailing address
4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558
Phone (301) 704-7385
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03679 | MD | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772064000000",
"number": "1699628297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 SANGAMORE RD STE N100",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208162558",
"telephone_number": "301-704-7385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 SANGAMORE RD STE N100",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208162558",
"telephone_number": "301-704-7385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDECK",
"first_name": "TRACY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-02-16",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "03679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.