Individual provider Active NPI

Amy Shulkin, PH.D.

  • Clinical Psychologist
  • Owings Mills, MD
National Provider Identifier
1720227655
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
02987 Issued in MD
Practice address
6 Park Center CT Ste 103
Owings Mills, MD 21117-5603
Phone
(410) 356-3344
Fax
(410) 356-4459
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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 02987 MD Primary

Addresses

Primary practice location

6 Park Center CT Ste 103
Owings Mills, MD 21117-5603

Mailing address

16 Lakeshire CT
Owings Mills, MD 21117-1246
Phone (410) 581-0469

Other names 1

  • Amy Tanick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161015000247 MD Practitioner - Clinical Psychologist 0244528784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Perspectives LLCGroup PAC ID 3870898109, 22 clinicians

Practice addresses (Care Compare)

6 Park Ctr CT
Suite 103
Owings Mills, MD 21117-5603
Phone 4103563344150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
02987MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Perspectives LLC Clinical CurrentSince Sep 13, 2016 Accepting new patients
Cynthia Voelz Clinical PastSince Sep 13, 2016 Accepting new patients

Locations

6 Park Center Ct
Ste 103
Owings Mills, MD 21117
Phone (410) 356-3344

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1720227655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LAKESHIRE CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171246",
            "telephone_number": "410-581-0469",
            "fax_number": "410-356-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARK CENTER CT STE 103",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175603",
            "telephone_number": "410-356-3344",
            "fax_number": "410-356-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULKIN",
        "first_name": "AMY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "TANICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.