Individual provider Active NPI

Carolyn Eichberg, PHD

  • Clinical Psychologist
  • Towson, MD
National Provider Identifier
1730353202
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
02395 Issued in MD
Practice address
901 Dulaney Valley Rd
Suite 129
Towson, MD 21204-2600
Phone
(410) 832-2729
Fax
(410) 832-5783
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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 02395 MD Primary

Addresses

Primary practice location

901 Dulaney Valley Rd
Suite 129
Towson, MD 21204-2600

Mailing address

901 Dulaney Valley Rd
Suite 129
Towson, MD 21204-2600
Phone (410) 832-2729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20081106000064 DC Practitioner - Clinical Psychologist 6901977172 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12605 Glen Rd
Potomac, MD 20854-1020

6121 Montrose Rd
Rockville, MD 20852-4803
Phone (301) 881-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02395MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Healthcare Group Past Accepting new patients

Organizations & group practices 1

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1730353202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DULANEY VALLEY RD",
            "address_2": "SUITE 129",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042600",
            "telephone_number": "410-832-2729",
            "fax_number": "410-832-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DULANEY VALLEY RD",
            "address_2": "SUITE 129",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042600",
            "telephone_number": "410-832-2729",
            "fax_number": "410-832-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHBERG",
        "first_name": "CAROLYN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.