NPIMap

Individual provider Active NPI

Michael Gene Tebeleff, PH.D.

  • Psychologist
  • Columbia, MD
National Provider Identifier
1962560375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
02551 Issued in MD
Practice address
8640 Guilford Rd
Suite 252
Columbia, MD 21046-2655
Phone
(410) 312-7250
Fax
(410) 312-7298
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

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
Psychologist 103T00000X 02551 MD Primary

Addresses

Primary practice location

8640 Guilford Rd
Suite 252
Columbia, MD 21046-2655

Mailing address

8640 Guilford Rd
Suite 252
Columbia, MD 21046-2655
Phone (410) 312-7250

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
02551MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa M. Ott, LCSW-C, LLC 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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962560375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 GUILFORD RD",
            "address_2": "SUITE 252",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462655",
            "telephone_number": "410-312-7250",
            "fax_number": "410-312-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 GUILFORD RD",
            "address_2": "SUITE 252",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462655",
            "telephone_number": "410-312-7250",
            "fax_number": "410-312-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBELEFF",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "02551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.