Individual provider Active NPI

Cherisse Rambarose

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1912521204
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
06880 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1832
Phone
(888) 554-2080
NPI assigned
Jun 2, 2020
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 06880 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1832

Mailing address

1741 Ashland Ave
Patient Accounting
Baltimore, MD 21205

Other practice location 1

9730 Patuxent Woods Dr Ste 100
Columbia, MD 21046-1626
Phone (443) 923-4360

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
I20240415003712 MD Practitioner - Clinical Psychologist 5698114254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06880MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Jan 30, 2024 Accepting new patients
Kennedy Krieger Associates CurrentSince Jan 30, 2024 Accepting new patients

Locations

1741 Ashland Ave
Baltimore, MD 21205
Phone (443) 923-1842

1741 Ashland Ave
Ste 642
Baltimore, MD 21205

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

9730 Patuxent Woods Dr
Ste 100
Columbia, MD 21046
Phone (240) 498-8984

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1912521204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "address_2": "PATIENT ACCOUNTING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "888-554-2080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 Patuxent Woods Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210461626",
            "country_code": "US",
            "telephone_number": "443-923-4360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMBAROSE",
        "first_name": "CHERISSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06880",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.