Active NPI
Susan Mandell
- Clinical Psychologist
- Frostburg, MD
National Provider Identifier
1750915765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 06278
- Practice address
- 101 Braddock Rd
Frostburg, MD 21532-2303 - Phone
- (301) 687-4234
- NPI assigned
- Feb 28, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 06278 | MD | Primary |
Addresses
Primary practice location
101 Braddock Rd
Frostburg, MD 21532-2303
Mailing address
29 Teaberry LN
Frostburg, MD 21532-2318
Other practice location 1
12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-8585
Other practice location 2
12502 Willowbrook Rd Ste 380
Cumberland, MD 21502-6592
Phone (240) 964-8585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06278 | MD | MD | Mental Health Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upmc Western Maryland Corporation | Past | Accepting new patients | |
| Upmc Western Maryland Health Services, LLC | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- Cumberland, MD
- NPI 1285779884
-
- Internal Medicine Physician
- Cumberland, MD
- NPI 1134844764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1750915765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 TEABERRY LN",
"city": "FROSTBURG",
"state": "MD",
"postal_code": "215322318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BRADDOCK RD",
"city": "FROSTBURG",
"state": "MD",
"postal_code": "215322303",
"telephone_number": "301-687-4234"
}
],
"practiceLocations": [
{
"address_1": "12500 Willowbrook Rd",
"address_purpose": "LOCATION",
"city": "Cumberland",
"state": "MD",
"postal_code": "215026393",
"country_code": "US",
"telephone_number": "240-964-8585",
"fax_number": "240-964-8586",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12502 Willowbrook Rd Ste 380",
"address_purpose": "LOCATION",
"city": "Cumberland",
"state": "MD",
"postal_code": "215026592",
"country_code": "US",
"telephone_number": "240-964-8585",
"fax_number": "240-964-8586",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANDELL",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-28",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "06278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frostburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.