Active NPI
Edward Spector, PSY.D.
- Clinical Psychologist
- Bethesda, MD
National Provider Identifier
1972648079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04197
- Practice address
- 4915 Auburn Ave
Ste. 110
Bethesda, MD 20814-2636 - Phone
- (202) 441-4834
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 04197 | MD | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 04197 | MD |
Addresses
Primary practice location
4915 Auburn Ave
Ste. 110
Bethesda, MD 20814-2636
Mailing address
4915 Auburn Ave
Ste. 110
Bethesda, MD 20814-2636
Phone (202) 441-4834
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 |
|---|---|---|---|
| 04197 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1972648079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4915 AUBURN AVE",
"address_2": "STE. 110",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142636",
"telephone_number": "202-441-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4915 AUBURN AVE",
"address_2": "STE. 110",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142636",
"telephone_number": "202-441-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPECTOR",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04197",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MD",
"license": "04197",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.