Active NPI
Erica Ann Lee, PSY.D.
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1760726640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05456
- Practice address
- 1708 W Rogers Ave
Department of Psychology
Baltimore, MD 21209-4545 - Phone
- (410) 578-2603
- Fax
- (410) 367-4197
- NPI assigned
- Nov 16, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 05456 | MD | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 05456 | MD | |
| Family Psychologist | 103TF0000X | 05456 | MD |
Addresses
Primary practice location
1708 W Rogers Ave
Department of Psychology
Baltimore, MD 21209-4545
Mailing address
1708 W Rogers Ave
Baltimore, MD 21209-4545
Phone (410) 578-2603
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05456 | MD | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1760726640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 W ROGERS AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094545",
"telephone_number": "410-578-2603",
"fax_number": "410-367-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 W ROGERS AVE",
"address_2": "DEPARTMENT OF PSYCHOLOGY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094545",
"telephone_number": "410-578-2603",
"fax_number": "410-367-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ERICA",
"middle_name": "ANN",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-16",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05456",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MD",
"license": "05456",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MD",
"license": "05456",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.