Provider Demographics
NPI:1407137961
Name:FIELDING PSYCHOLOGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FIELDING PSYCHOLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:L P
Authorized Official - Last Name:FIELDING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-868-4142
Mailing Address - Street 1:9051 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3927
Mailing Address - Country:US
Mailing Address - Phone:410-868-4142
Mailing Address - Fax:
Practice Address - Street 1:9051 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:SUITE 4B
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3927
Practice Address - Country:US
Practice Address - Phone:410-868-4142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04442103T00000X, 103TC0700X
MD04438103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty