Active NPI
Lilian Odera, PH.D.
- Psychologist
- Millersville, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05769
- Practice address
- 8258 Veterans Hwy Ste 13-15
Millersville, MD 21108-1457 - Phone
- (410) 757-2077
- NPI assigned
- Aug 30, 2012
- Sex
- Female
- 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 | PY7889 | FL | |
| Psychologist | 103T00000X | 05769 | MD | Primary |
Addresses
Primary practice location
8258 Veterans Hwy Ste 13-15
Millersville, MD 21108-1457
Mailing address
8258 Veterans Hwy Ste 13-15
Millersville, MD 21108-1457
Phone (410) 757-2077
Other practice location 1
7600 Red Road
129
South Miami, FL 33143
Phone (305) 608-6025
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1662 Village GRN
Crofton, MD 21114-2014
Phone (410) 757-2077
2650 Quarry Lake Dr
Suite 200
Baltimore, MD 21209-3756
Phone (410) 757-2077
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05769 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arundel Mental Health Professionals L.C. | Clinical | Current | Accepting new patients |
| Arundel Mental Health Professionals LLC | Clinical | Past | Accepting new patients |
Locations
1511 Ritchie Hwy
Ste 202
Arnold, MD 21012
Phone (410) 757-5184
2650 Quarry Lake Dr
Ste 200
Baltimore, MD 21209
1662 Village Grn
#B
Crofton, MD 21114
1662 Village Grn
Crofton, MD 21114
Phone 4107572077 ext. 8137
8258 Veterans Hwy
Ste 13
Millersville, MD 21108
Phone (410) 768-6088
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Arnold, MD
- NPI 1073649521
-
- Clinical Psychologist
- Baltimore, MD
- NPI 1083340830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1992054324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8258 VETERANS HWY STE 13-15",
"city": "MILLERSVILLE",
"state": "MD",
"postal_code": "211081457",
"telephone_number": "410-757-2077",
"fax_number": "443-782-2342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8258 VETERANS HWY STE 13-15",
"city": "MILLERSVILLE",
"state": "MD",
"postal_code": "211081457",
"telephone_number": "410-757-2077"
}
],
"practiceLocations": [
{
"address_1": "7600 Red Road",
"address_2": "129",
"address_purpose": "LOCATION",
"city": "South Miami",
"state": "FL",
"postal_code": "33143",
"country_code": "US",
"telephone_number": "305-608-6025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODERA",
"first_name": "LILIAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY7889",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Millersville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.