Active NPI
Anjanette Jaye Blunt
- Clinical Psychologist
- Waldorf, MD
National Provider Identifier
1912612748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- A0880
- Practice address
- 3261 Old Washington Rd Ste 2020
Waldorf, MD 20602-3231 - Phone
- (443) 873-0835
- NPI assigned
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | A0880 | MD | Primary |
Addresses
Primary practice location
3261 Old Washington Rd Ste 2020
Waldorf, MD 20602-3231
Mailing address
110 Waters LNDG
Stafford, VA 22554-7833
Phone (301) 693-7440
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0880 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1912612748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WATERS LNDG",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225547833",
"telephone_number": "301-693-7440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3261 OLD WASHINGTON RD STE 2020",
"city": "WALDORF",
"state": "MD",
"postal_code": "206023231",
"telephone_number": "443-873-0835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUNT",
"first_name": "ANJANETTE",
"middle_name": "JAYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-17",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "A0880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.