Active NPI
Jonathan R. Schettino, PH.D
- Psychologist
- Baltimore, MD
National Provider Identifier
1770883746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05237
- Practice address
- 1014 W 36TH St # 205
Baltimore, MD 21211-2415 - Phone
- (410) 941-8172
- NPI assigned
- Oct 25, 2010
- Last updated
- Jun 20, 2023
- Sex
- Male
- 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 | 05237 | MD | Primary |
Addresses
Primary practice location
1014 W 36TH St # 205
Baltimore, MD 21211-2415
Mailing address
3726 Hickory Ave
Baltimore, MD 21211-1809
Phone (401) 941-8172
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 |
|---|---|---|---|
| 05237 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychforward LLC | Psychologist | Current | 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": "1287964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1770883746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3726 HICKORY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111809",
"telephone_number": "401-941-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 W 36TH ST # 205",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112415",
"telephone_number": "410-941-8172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHETTINO",
"first_name": "JONATHAN",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-25",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05237",
"primary": true
}
],
"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 Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.