Individual provider Active NPI

Lynn Witkin-Weinstein, PH.D.

  • Clinical Psychologist
  • Ellicott City, MD
National Provider Identifier
1912299918
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1361 Issued in MD
Practice address
4260 Lilac LN
Ellicott City, MD 21042-5957
Phone
(410) 480-1606
NPI assigned
May 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2011

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 1361 MD Primary

Addresses

Primary practice location

4260 Lilac LN
Ellicott City, MD 21042-5957

Mailing address

4260 Lilac LN
Ellicott City, MD 21042-5957
Phone (410) 480-1606

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

LicenseStateTypeSpecialty
1361MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1912299918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 LILAC LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425957",
            "telephone_number": "410-480-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 LILAC LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425957",
            "telephone_number": "410-480-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKIN-WEINSTEIN",
        "first_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "1361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.