LILLIAN M. EARLE EDD, NPI 1235115445 — CUMBERLAND (MD)

NPI 1235115445

14+ Years Experience Individual

LILLIAN M. EARLE EDD

12/20/2005
PROVIDER ENUMERATION DATE
09.11.2007
LAST UPDATE DATE
1235115445
NPI NUMBER

About LILLIAN M. EARLE

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

LILLIAN M. EARLE is a provider established in CUMBERLAND, MD. The NPI number of LILLIAN M. EARLE is 1235115445 and was assigned on 12/20/2005. The practitioners primary taxonomy code is: 103TC1900X with license number: 2510 MD .

Mailing address

  • City: FROSTBURG
  • State: MD
  • Postal code: 21532
  • Address: 108 BROADWAY STREET

Primary Practice Address

  • Region : CUMBERLAND, MD
  • NPI : 1235115445
  • Phone : 3017231443
  • Fax : 3017231480
  • Postalcode : 21502
  • Address : 900 SETON DR 2ND FLOOR

Additional identifiers

  • Identifier: 58360
  • Code / Type : 1 - other
  • Identifier state :
  • Identifier issuer: HORIZON HEALTH

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: M093 0008
  • Code / Type : 1 - other
  • Identifier state : DC
  • Identifier issuer : BLUE CHOICE

Provider taxonomy - Psychologist

  • Taxonomy code: 103TC1900X
  • License number: 2510
  • License state: MD

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Contacts:

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  • LILLIAN M. EARLE EDD
  • Address : 900 SETON DR 2ND FLOOR
  • Region : CUMBERLAND, MD
  • NPI : 1235115445
  • Phone : 3017231443
  • Fax : 3017231480
  • Postalcode : 21502

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address900 SETON DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address2ND FLOOR
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCUMBERLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code21502
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017231443
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017231480
The fax number associated with the location address of the provider being identified.
NPI1235115445
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1103TC1900X
A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
Provider Enumeration Date12/20/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated09.11.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)LILLIAN M. EARLE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address108 BROADWAY STREET
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameFROSTBURG
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code21532
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Healthcare Provider Taxonomy Code #1103TC1900X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Psychologist
A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
Provider License Number 12510
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MD
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 158360
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier Issuer 1HORIZON HEALTH
Other Provider Identifier Issuer #1
Other Provider Identifier 2M093 0008
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2DC
Other Provider Identifier State #2
Other Provider Identifier Issuer 2BLUE CHOICE
Other Provider Identifier Issuer #2
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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