NPIMap

Organization Active NPI

Insideout Psychological Services, LLC

  • Clinical Psychologist
  • Clinton, MD
National Provider Identifier
1821462557
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05186 Issued in MD
Legal business name
INSIDEOUT PSYCHOLOGICAL SERVICES, LLC
Practice address
2811 Pumpkin St
Clinton, MD 20735-1063
Phone
(301) 275-6737
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Dr. M Renee Mottenon-Thompson, PSYD
Title
Owner/Operator
Phone
(301) 275-6737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 05186 MD Primary

Addresses

Primary practice location

2811 Pumpkin St
Clinton, MD 20735-1063

Mailing address

2811 Pumpkin St
Clinton, MD 20735-1063
Phone (301) 275-6737

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1821462557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 PUMPKIN ST",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351063",
            "telephone_number": "301-275-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 PUMPKIN ST",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351063",
            "telephone_number": "301-275-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIDEOUT PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "MOTTENON-THOMPSON",
        "authorized_official_first_name": "M RENEE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "301-275-6737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.