Renita Cherise Gabriel, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04624 Issued in MD

Practice address

1641 Maryland RT 3 N Ste 201
Crofton, MD 21114-2464

Phone

(240) 709-3029

NPI assigned

Jun 27, 2008

Last updated

Jan 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Breakthroughs Psychological Services, LLC

  • Clinical Psychologist
  • Crofton, MD
  • NPI 1497310676
  NPD Authorized official
• Safe Harbor Christian Counseling LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1245377894
  NPD

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1932361391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 RIVER PARK RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153343",
            "telephone_number": "301-412-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 MARYLAND RT 3 N STE 201",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142464",
            "telephone_number": "240-709-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "RENITA",
        "middle_name": "CHERISE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Circle Home Care, LLC (Full Circle Youth & Family Center)
• Full Circle Home Care, LLC (Full Circle Youth & Family Center)
• Sunny L Fulton
• Allison Nicole Funk, ATC
• Eric John Gabriel, D.D.S.
• Barbara Galuska, LCSW-C
• Deborah E Gammill
• Kaylyn Nicole Garcia, RBT
• Oliver Garver
• Genuine Lactation, LLC

• Clinical Psychologist in Crofton, MD
• Providers in Crofton, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.