Individual provider Active NPI

Judith Clifford

  • Clinical Psychologist
  • Annapolis, MD
National Provider Identifier
1831590132
Registry record updated Sep 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04928 Issued in MD
Practice address
512 State St
Annapolis, MD 21403-3239
Phone
(443) 822-7490
NPI assigned
Sep 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04928 MD Primary

Addresses

Primary practice location

512 State St
Annapolis, MD 21403-3239

Mailing address

512 State St
Annapolis, MD 21403-3239
Phone (443) 822-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151229000821 MD Practitioner - Clinical Psychologist 7810298361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

512 State St
Annapolis, MD 21403-3239
Phone (443) 290-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04928MDMDOccupational Therapist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1831590132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 STATE ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214033239",
            "telephone_number": "443-822-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 STATE ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214033239",
            "telephone_number": "443-822-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "JUDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.