Individual provider Active NPI

Constance Halligan, PH.D.

  • Clinical Psychologist
  • Ellicott City, MD
National Provider Identifier
1962543983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3499 Issued in MD
Practice address
5022 Dorsey Hall Dr
Suite 101
Ellicott City, MD 21042-7711
Phone
(410) 730-7333
NPI assigned
Feb 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3499 MD Primary

Addresses

Primary practice location

5022 Dorsey Hall Dr
Suite 101
Ellicott City, MD 21042-7711

Mailing address

5022 Dorsey Hall Dr
Suite 101
Ellicott City, MD 21042-7711

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
I20091106000311 MD Practitioner - Clinical Psychologist 5799823019 Practice locations: Ellicott City, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5300 Dorsey Hall Dr
Suite 203
Ellicott City, MD 21042-7818
Phone (410) 730-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3499MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Psychotherapy Insititute, LTD Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962543983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 DORSEY HALL DR",
            "address_2": "SUITE 101",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 DORSEY HALL DR",
            "address_2": "SUITE 101",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427711",
            "telephone_number": "410-730-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIGAN",
        "first_name": "CONSTANCE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "3499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.