SHELLEY MULLEN MCDERMOTT (NPI# 1336307800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336307800 |
| Entity Type | Individual |
| Full Name | SHELLEY MULLEN MCDERMOTT |
| Credential | PHD, BCBA |
| Practice Address |
1750 E Fairmount Ave Baltimore MD 21231-1534 |
| Practice Telephone | 4439239400 |
| Mailing Telephone | 4439239400 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2014-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 05422 | MD | Behavioral Health & Social Service Providers |
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
1750 E FAIRMOUNT AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21231-1534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789877 | Jennifer L Pritchard | Speech-Language Pathologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2006-02-16 |
| 1164036745 | Courtney Kaczmarek | Speech-Language Pathologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2020-09-01 |
| 1649805052 | Danielle Previ | Psychologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2020-03-05 |
| 1255975306 | Shalom Shapiro | Clinical Neuropsychologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-11-01 |
| 1700436912 | Neha Sharma | Speech-Language Pathologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-09-19 |
| 1699329573 | Sarah B Harris | Speech-Language Pathologist | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-07-29 |
| 1982256814 | Sandra Rodgin | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-07-11 |
| 1225694565 | Ashley Marie Boyle | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-05-13 |
| 1538724141 | Danielle Brooke Willis | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-05-08 |
| 1043875941 | Kaitlin Gould | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave, Baltimore, MD 21231-1534 | 2019-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356901102 | Danielle Wexler | Student in an Organized Health Care Education/Training Program | 1750 E Fairmount Ave Fl 3, Baltimore, MD 21231 | 2019-06-14 |
| 1427615822 | Elana Rachel Kagan | Psychologist | 1750 East Fairmont Ave, Baltimore, MD 21231 | 2019-05-22 |
| 1982196176 | Gabriel Ewing | Massage Therapist | Sanctuary Bodyworks, 710 S. Ann St. #210, Baltimore, MD 21231 | 2018-06-04 |
| 1306358098 | Zachary Woods | Chiropractor | 2001 Eastern Avenue, 1st Floor, Baltimore, MD 21231 | 2017-11-02 |
| 1396191458 | The Johns Hopkins Hospital | Pharmacy | 401 N. Broadway, Suite 1001, Baltimore, MD 21231 | 2016-05-09 |
| 1235593468 | Saurabh Raj Pandey | Pharmacist | 919 N Caroline St, Baltimore, MD 21231 | 2016-04-13 |
| 1306251202 | Clare Gibson | Psychologist | 2240 East Baltimore St, Baltimore, MD 21231 | 2014-06-30 |
| 1245645514 | Marie Woods | Psychologist | 14 S. Broadway St., Baltimore, MD 21231 | 2014-06-25 |
| 1003226234 | Rebecca Delaney Tsao | Nurse Practitioner | 98 North Broadway, Suite 421, Baltimore, MD 21231 | 2014-04-28 |
| 1265856488 | Paul Laurence Dunbar High School | Clinic/Center | 1400 Orleans Street, Baltimore, MD 21231 | 2014-02-07 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020543 | Virginia Samford Hornbeck | Psychologist | 1400 W Cold Spring Ln, Baltimore, MD 21209-4904 | 2019-06-04 |
| 1427615822 | Elana Rachel Kagan | Psychologist | 1750 East Fairmont Ave, Baltimore, MD 21231 | 2019-05-22 |
| 1891218947 | Sahar Moise | Psychologist | 1708 West Rogers Avenue, Baltimore, MD 21209-4596 | 2017-07-20 |
| 1447787734 | Brittany Renee Patterson | Psychologist | 737 West Lombard St., Baltimore, MD 21201-2120 | 2017-05-17 |
| 1861845224 | Andrea Goddard | Psychologist | 720 Aliceanna Street, Baltimore, MD 21202 | 2016-07-20 |
| 1164870614 | Shauna Lynne | Psychologist | 1750 E Fairmount Ave Fl 4, Baltimore, MD 21231-1534 | 2016-05-25 |
| 1073985081 | Denise Bike | Psychologist | 600 Wyndhurst Ave Ste 200-a, Baltimore, MD 21210-2489 | 2015-10-29 |
| 1982087003 | Rachel Cymber Lafleur | Psychologist | 711 W 40th St # 153-363, Baltimore, MD 21211-2120 | 2015-07-07 |
| 1346639713 | Eboka Mullins | Psychologist | 419 W Redwood St Ste 570, Baltimore, MD 21201-7023 | 2015-01-22 |
| 1306251202 | Clare Gibson | Psychologist | 2240 East Baltimore St, Baltimore, MD 21231 | 2014-06-30 |
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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.