MONOCACY NEURODEVELOPMENTAL CENTER (NPI# 1578619961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578619961 |
| Entity Type | Organization |
| Organization Name | MONOCACY NEURODEVELOPMENTAL CENTER |
| Practice Address |
65 Thomas Johnson Dr Suite A Frederick MD 21702-4371 |
| Practice Telephone | 3016623808 |
| Mailing Telephone | 3016623808 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SCOTT THOMAS WINGET (DIRECTOR) |
| Authorized Official Telephone | 3016623808 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
65 THOMAS JOHNSON DR SUITE A |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546994 | Regina Kundell | Nurse Practitioner | 65 Thomas Johnson Dr, C, Frederick, MD 21702-4371 | 2005-05-27 |
| 1770115875 | Stefanie Cullum | Behavior Technician | 65 Thomas Johnson Dr, Frederick, MD 21702-4371 | 2020-02-06 |
| 1871137505 | Alyssa Heflin | Behavior Technician | 65 Thomas Johnson Dr, Frederick, MD 21702-4371 | 2019-11-06 |
| 1144874413 | Rebecca Kucevic | Behavior Technician | 65 Thomas Johnson Dr, Frederick, MD 21702-4371 | 2019-07-25 |
| 1205288271 | Christina Wagoner | Counselor | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2016-07-01 |
| 1649637554 | Laren Anderson | Counselor | 65 Thomas Johnson Dr, #a Attn: Laren Anderson, Frederick, MD 21702-4371 | 2016-01-22 |
| 1366838617 | Kelsey Sue Eaton | Community Health Worker | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2015-04-14 |
| 1871986075 | Sam Specht | Community Health Worker | 65 Thomas Johnson Dr, Suite A, Frederick, MD 21702-4371 | 2015-03-12 |
| 1407247638 | Emma Rivera | Community Health Worker | 65 Thomas Johnson Dr, Ste A, Frederick, MD 21702-4371 | 2015-02-10 |
| 1255746020 | Todd Phillips | Physical Therapist | 65 Thomas Johnson Dr, Suite D, Frederick, MD 21702-4371 | 2014-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053756908 | Shouh-rong Vivian Tsai | Psychologist | 5301 Buckeystown Pike Ste 440, Frederick, MD 21704-8319 | 2013-05-06 |
| 1386876811 | Monica Kristine Pentony | Psychologist | 10142 Hansonville Rd, Frederick, MD 21702-1919 | 2009-08-18 |
| 1205002029 | Helene G Brenner | Psychologist | 97 S Mccain Dr, Ste. B, Frederick, MD 21703-6055 | 2008-05-01 |
| 1194906180 | Elise G. Abromson | Psychologist | 620 W Patrick St, Frederick, MD 21701-4028 | 2007-11-18 |
| 1316146566 | Maryland Counseling Centers, Inc. | Psychologist | 5300 Westview Dr., Bldg. 100, Suite 104, Frederick, MD 21703-8327 | 2007-07-17 |
| 1710193156 | Margaret Rose Bowman | Psychologist | 1497 Dogwood Dr, Frederick, MD 21701-4487 | 2007-05-15 |
| 1316163090 | John Patrick Farrell | Psychologist | 97b S Mccain Dr, Frederick, MD 21703-6055 | 2007-04-18 |
| 1396877189 | Health and Happiness LLC | Psychologist | 93 S Mccain Drive, Frederick, MD 21703 | 2007-03-09 |
| 1649363037 | Brenda Ann Vidal | Psychologist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2006-09-30 |
| 1487766788 | Jennifer L Carter | Psychologist | 97 S Mccain Dr # B, Frederick, MD 21703-6055 | 2006-08-31 |
| Find all providers in FREDERICK | ||||
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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.