Organization Active NPI

Psychexperts & Associates

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1720469562
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05046 Issued in MD
Legal business name
PSYCHEXPERTS & ASSOCIATES
Practice address
5707 Calverton St
Suite 1-D
Baltimore, MD 21228-4154
Phone
(410) 251-2100
Fax
(410) 777-8130
NPI assigned
Jun 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Dr. Beverli Mormile, PSY.D.NPI 1801152954
Title
President
Phone
(410) 777-8130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 05046 MD Primary

Addresses

Primary practice location

5707 Calverton St
Suite 1-D
Baltimore, MD 21228-4154

Mailing address

611 Park Ave
Suite 1-D
Baltimore, MD 21201-4572
Phone (410) 777-8130

Other identifiers 2

IdentifierTypeStateIssuer
4979001-00MedicaidMD
243136OtherMDMEDICARE P-TAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1720469562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 PARK AVE",
            "address_2": "SUITE 1-D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014572",
            "telephone_number": "410-777-8130",
            "fax_number": "410-777-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 CALVERTON ST",
            "address_2": "SUITE 1-D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284154",
            "telephone_number": "410-251-2100",
            "fax_number": "410-777-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHEXPERTS & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "MORMILE",
        "authorized_official_first_name": "BEVERLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-777-8130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4979001-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "243136",
            "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 Jun 17, 2015; 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.