Active NPI
Gwen Lynne Martinsen, PH.D.
- Psychologist
- Columbia, MD
National Provider Identifier
1760508097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 02637
- Practice address
- 9424 Bullring LN
Columbia, MD 21045-4409 - Phone
- (410) 963-9670
- Fax
- (410) 997-0675
- NPI assigned
- Mar 21, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 02637 | MD | Primary |
Addresses
Primary practice location
9424 Bullring LN
Columbia, MD 21045-4409
Mailing address
9424 Bullring LN
Columbia, MD 21045-4409
Phone (410) 963-9670
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02637 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760508097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9424 BULLRING LN",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454409",
"telephone_number": "410-963-9670",
"fax_number": "410-997-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9424 BULLRING LN",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454409",
"telephone_number": "410-963-9670",
"fax_number": "410-997-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINSEN",
"first_name": "GWEN",
"middle_name": "LYNNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "02637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.