Active NPI
Carolyn Eichberg, PHD
- Clinical Psychologist
- Towson, MD
National Provider Identifier
1730353202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 02395
- 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
- Last updated
- Jan 18, 2024
- 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 | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 02395 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.