Amy Waldron

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC5286 Issued in MD

Practice address

1205 York Rd
300 C
Lutherville, MD 21093-6210

Phone

(410) 998-3920

Fax

(410) 998-3931

NPI assigned

Oct 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 6, 2024 through Mar 6, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bergand Group

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lutherville, MD
  • NPI 1407113483
  NPD (past)
• Clinical Lab Solutions

  • Clinical Medical Laboratory
  • Lutherville, MD
  • NPI 1629481999
  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1912301722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 YORK RD STE 300C",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936019",
            "telephone_number": "410-853-7691",
            "fax_number": "443-519-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "300 C",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-998-3920",
            "fax_number": "410-998-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC5286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rupal Vyas
• Ariel Megan Wagerman
• Max Wagonheim, PTA
• Christopher J Wahlgren, M.D.
• Rebecca Walden
• Walgreen Co
• Walgreen Co
• Walgreen Co.
• Edward Wallach, M.D.
• Susanne Schoppert Wallengren, D.D.S.

• Professional Counselor in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.