FREDERICK PSYCHIATRIC MEDICINE NPI 1619411121

NPI Information

  • NPI: 1619411121
  • Provider Name: FREDERICK PSYCHIATRIC MEDICINE
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Organization
  • CLIA Number: 21D2302796
  • Address: 10001 PEBBLE BEACH TER
    IJAMSVILLE, MD
    ZIP 21754
  • Phone: (301) 606-7785

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NPI Details

FREDERICK PSYCHIATRIC MEDICINE is a psychiatry psychiatry neurology in Ijamsville, MD. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. FREDERICK PSYCHIATRIC MEDICINE NPI is 1619411121. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10001 PEBBLE BEACH TER
IJAMSVILLE, MD
ZIP 21754-147
Phone: (301) 606-7785
Fax: (240) 310-1927

The provider's authorized official is Corvin Robinson .
The authorized official title is Owner and has the following contact phone number (301) 606-7785.

The CLIA number assigned to this NPI record is 21D2302796 - other - out patient ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2016 and was last updated on 12/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatryDOO44857MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F97005MEDICARE UPINMARYLAND
2SX173OTHERMARYLANDBEACON HEALTH
3D0044857OTHERMARYLANDMEDICAL LICENSE
4MDMCDMEDICAIDMARYLAND
560054OTHERMARYLANDAETNA
600823OTHERVALUE OPTIONS
7SB580OTHERMARYLANDBLUE CROSS/BLUE SHIELD
8SKMDOMEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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