Johari Makeba Massey, M.A., M.S., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05339 Issued in MD

Practice address

2020 Russell Ave
Gwynn Oak, MD 21207-5219

Phone

(646) 246-9655

Fax

(410) 944-6290

NPI assigned

Aug 31, 2007

Last updated

Feb 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MD

  Medicare reassignment Care Compare group NPD
• Wagner Medical PC

  dba SonderMind

  • Clinical Social Worker
  • Toms River, NJ
  • NPI 1235951187

  NY

  Medicare reassignment NPD
• Columbia Counseling Center P.a.

  • Mental Health Counselor
  • Columbia, MD
  • NPI 1578504296
  NPD

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1821282807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 N ROLLING RD UNIT 47071",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212447603",
            "telephone_number": "443-272-5347",
            "fax_number": "410-944-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RUSSELL AVE",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075219",
            "telephone_number": "646-246-9655",
            "fax_number": "410-944-6290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2513 N Rolling Rd Unit 47071",
            "address_purpose": "LOCATION",
            "city": "Windsor Mill",
            "state": "MD",
            "postal_code": "212447603",
            "country_code": "US",
            "telephone_number": "443-272-5347",
            "fax_number": "410-944-6290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "JOHARI",
        "middle_name": "MAKEBA",
        "name_prefix": "Dr.",
        "credential": "M.A., M.S., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "05339",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019895",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "05339",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loving Arms, Inc
• Loving Hearts ABA LP
• Cecilia Mahle, MS, OTR/L CBIS
• Marathon Community Wellness. Inc.
• Maryland General Clinical Practice Group, Inc.
• Kristin Yolanda Matthews, LPC
• Stella Ebere Mbah, CRNP
• Grace Mbakop
• Bobby C McQueen-Bey, LCADC
• Mdics at Umroi, LLC

• Clinical Psychologist in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.