KENNEDY KRIEGER ASSOCIATES, INC. (NPI# 1053572958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053572958 |
| Entity Type | Organization |
| Organization Name | KENNEDY KRIEGER ASSOCIATES, INC. |
| Other Organization Name | KENNEDY KRIEGER INSTITUTE |
| Practice Address |
707 N. Broadway Baltimore MD 21205 |
| Mailing Address |
P.o. Box 744865 Atlanta GA 30374 |
| Practice Telephone | 4439239200 |
| Practice Fax Number | 4439239405 |
| Mailing Telephone | 4439231886 |
| Mailing Fax Number | 4439231895 |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | MR. MIKE NEUMAN (VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 4439231810 |
| Is Organization Subpart | Y |
| Parent Organization Name | KENNEDY KRIEGER INSTITUTE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
30036 | MD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 414602600 | 05 |
| Other Name | Type Code |
|---|---|
| Kennedy Krieger Institute | Other Name - Individual/Organization |
| Street Address |
707 N. BROADWAY |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043261043 | Sakkubai Naidu | Psychiatry & Neurology | 707 N. Broadway, Baltimore, MD 21205 | 2006-05-14 |
| 1073138715 | Christine Pho | Student in an Organized Health Care Education/Training Program | 707 N. Broadway, Baltimore, MD 21205 | 2020-06-09 |
| 1215327259 | Kennedy Krieger Associates, Inc - Mental Health Group Provider | Clinic/Center | 707 N. Broadway, Baltimore, MD 21205 | 2015-01-29 |
| 1679979686 | Aishah Aifadhalah | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2014-11-18 |
| 1033478623 | Mindy Lee Cavendish | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2012-05-16 |
| 1952625675 | Bradley R Grant | Psychiatry & Neurology | 707 N. Broadway, Baltimore, MD 21205 | 2010-03-24 |
| 1164638391 | Kennedy Krieger Children's Hospital, Inc. | Durable Medical Equipment & Medical Supplies | 707 N. Broadway, Baltimore, MD 21205 | 2007-05-15 |
| 1881800027 | Kennedy Krieger Children's Hospital, Inc. | Chronic Disease Hospital | 707 N. Broadway, Baltimore, MD 21205 | 2007-05-15 |
| 1629199708 | Carrie Roylance Zetlmeisi | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2007-04-03 |
| 1982750543 | Suzanne Marie Rybczynski | Pediatrics | 707 N. Broadway, Baltimore, MD 21205 | 2007-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467019034 | Meghna Rajaprakash | Student in an Organized Health Care Education/Training Program | 716 N Broadway, Rm 431, Baltimore, MD 21205 | 2019-05-20 |
| 1871158592 | Rachel Samantha Bronheim | Student in an Organized Health Care Education/Training Program | 610 N Caroline St, 5th Floor, Baltimore, MD 21205 | 2019-05-08 |
| 1700342250 | Ruth Leeanna Williams | Social Worker | 504 N. Caroline Street, Baltimore, MD 21205 | 2019-02-20 |
| 1174017032 | Anna Kathryn Chassevent | Genetic Counselor, MS | 801 N. Broadway, Baltimore, MD 21205 | 2018-06-14 |
| 1588115653 | Redeem Healthcare and Medical System Inc | Case Management | 917 North Caroline Street, Baltimore, MD 21205 | 2016-10-24 |
| 1013334929 | Crystal Diane Salcido | Psychiatry & Neurology | 855 N Wolfe St Ste 300, Baltimore, MD 21205 | 2014-03-28 |
| 1487088464 | Laura Mitchell | Nurse Practitioner | 707 N. Broadway Ave, Baltimore, MD 21205 | 2013-08-27 |
| 1477992410 | Ferbet Take Care Health Maryland, P.C. | Nurse Practitioner | 900 N. Washington Street, Baltimore, MD 21205 | 2013-06-24 |
| 1225370570 | Amena Smith Fine | Pediatrics | Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205 | 2013-03-25 |
| 1356695993 | Kalpana Prasad | Student in an Organized Health Care Education/Training Program | 800 North Wolfe St., John G. Rangos, Sr. Building, Room 248, 2nd Floor, Baltimore, MD 21205 | 2012-11-05 |
| Find all providers in zip 21205 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969802 | Together We Rise LLC | Psychologist | 1014 W 36th St, Baltimore, MD 21211-2415 | 2020-07-10 |
| 1225438344 | Marjorie Katherine Mccalla | Psychologist | 720 Aliceanna St, Baltimore, MD 21202-4387 | 2014-08-26 |
| 1528391737 | Tara Mathews | Psychologist | Division of Child and Adolescent Psychiatry, 600 N. Wolfe Street/ Cmsc 376, Baltimore, MD 21287-0001 | 2009-09-08 |
| 1265618961 | Kimberly Dyan Becker | Psychologist | 600 N Wolfe Street/cmsc 346, Baltimore, MD 21287-0001 | 2008-01-14 |
| 1881807899 | Julie E Kingery | Psychologist | 600 North Wolfe Street, Cmsc 346, Division of Child and Adolescent Psychiatry, Baltimore, MD 21287 | 2007-05-07 |
| 1316161821 | Sharon Jenny Green-hennessy | Psychologist | 5911 York Rd, Suite 100 Loyola Clinical Centers, Baltimore, MD 21212-3048 | 2007-04-13 |
| 1396366274 | Samantha Noelle Hartley | Psychologist | 10 N Greene St, Baltimore, MD 21201-1524 | 2020-05-01 |
| 1376199711 | Marissa Miller | Psychologist | 1708 W Rogers Ave, Baltimore, MD 21209-4545 | 2019-08-12 |
| 1083178578 | Kara Koenig | Psychologist | 1708 W Rogers Ave, Baltimore, MD 21209-4545 | 2019-01-29 |
| 1740776996 | Anna Davis | Psychologist | 701 W Pratt St, Baltimore, MD 21201-1023 | 2018-07-10 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.