Joshua Childers, PSY.D. – Clinical Psychologist

Key facts

NPI: 1740409473
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: PSY004213 (GA)
Practice address: 507 Ocean Blvd Ste 201
St Simons Island, GA 31522-4819
Phone: (912) 399-9223
Fax: (614) 543-0426
NPI assigned: Apr 24, 2007
Sex: Male
Sole proprietor: Yes

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.

Charm City Psychotherapy Mental Health Clinic/Center (Including Community Mental Health Center) · Lutherville Timonium, MD · NPI 1265238471

Medicare reassignment NPD Authorized official MD
Psychogeriatric Services LLC Psychiatry Physician · Columbia, MD · NPI 1588689483

Medicare reassignment Care Compare group NPD MD

Medicare Care Compare profile

Specialty: Clinical Psychologist
Education: Other, 2005
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Psychogeriatric Services LLC (122 clinicians)

Practice addresses (Care Compare)

118 Galewood Rd
Lutherville Timonium, MD 21093-2511
Phone (912) 399-9223

4101 Old National Pike
Pleasant View NH
Mt Airy, MD 21771-4115
Phone (301) 831-5850

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20230427001775	MD	Practitioner - Clinical Psychologist	7012372972	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
PSY004213	GA	MD	Clinical Psychologist
06817	MD	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Charm City Psychotherapy		Current since Jan 10, 2025	Accepting new patients
Psychogeriatric Services LLC		Current since Jan 30, 2023	Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist	103TC0700X	PSY004213	GA	Yes

Addresses

Primary practice location

507 Ocean Blvd Ste 201
St Simons Island, GA 31522-4819

Mailing address

804 Sand Dollar Trce
Saint Simons Island, GA 31522-3758
Phone (912) 399-9223

Other providers in St Simons Island, GA

Ralph Cavalier, M.D.
Centered for Life, Inc
Amy Lynn Chaffin, APRN, PMHNP-BC
Rahul Anil Changela, PHARMD
Stephanie Rene Chapman, D.O.
Emily K Claros, DPT, PT
Brandon R Clements, D.M.D.
Coastal Community Health Services, Inc.
Coastal Community Retirement Corporation
Coastal Community Retirement Corporation

All providers in St Simons Island, GA · Clinical Psychologist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.