Individual provider Active NPI

Cynthia A Smith-Seidel, PHD

  • Clinical Neuropsychologist
  • Baltimore, MD
National Provider Identifier
1801966593
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
03713 Issued in MD
Practice address
1708 W Rogers Ave
Baltimore, MD 21209-4545
Phone
(410) 578-8600
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 03713 MD Primary

Addresses

Primary practice location

1708 W Rogers Ave
Baltimore, MD 21209-4545

Mailing address

5051 Greenspring Ave
Suite300
Baltimore, MD 21209-4354
Phone (410) 601-7351

Other identifiers 1

IdentifierTypeStateIssuer
688002900MedicaidMD

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03713MDMDClinical Neuropsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1801966593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 GREENSPRING AVE",
            "address_2": "SUITE300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094354",
            "telephone_number": "410-601-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094545",
            "telephone_number": "410-578-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-SEIDEL",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "03713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688002900",
            "state": "MD"
        }
    ],
    "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 Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.