| Middleton Psychology Services, Llc | |
|
186 Thomas Johnson Dr Ste 204 Frederick MD 21702-4478 | |
| (301) 360-5859 | |
| Not Available |
| Full Name | Middleton Psychology Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 186 Thomas Johnson Dr Ste 204, Frederick, Maryland |
| Authorized Official Name and Position | Carl Middleton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3013605859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middleton Psychology Services, Llc 186 Thomas Johnson Drive Suite 204 Frederick MD 21702 Ph: (301) 360-5859 | Middleton Psychology Services, Llc 186 Thomas Johnson Dr Ste 204 Frederick MD 21702-4478 Ph: (301) 360-5859 |
| NPI Number | 1134579626 |
|---|---|
| Provider Enumeration Date | 06/15/2016 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Medicare PECOS PAC ID | 3274910575 |
|---|---|
| Medicare Enrollment ID | O20220505002254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134579626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Roseanne M Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699737346 PECOS PAC ID: 2163459785 Enrollment ID: I20110825000256 |
| Provider Name | Carl Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255436671 PECOS PAC ID: 0446536395 Enrollment ID: I20170410000145 |
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