DR. BRENDA ANN VIDAL (NPI# 1649363037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649363037 |
Entity Type | Individual |
Full Name | DR. BRENDA ANN VIDAL |
Credential | PSY.D. |
Practice Address |
6441 Jefferson Pike Frederick MD 21703-7039 |
Mailing Address |
20227 Waters Row Ter Germantown MD 20874-3892 |
Practice Telephone | 3016686033 |
Mailing Telephone | 3019164415 |
Enumeration Date | 2006-09-30 |
Last Update Date | 2008-04-28 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
04302 | MD | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | BCBS MD | 60484701 | 01 |
DE | RR MEDICARE S | P00384922 | 01 |
MD | 412389100 | 05 | |
DC | BCBS DC | G3960046 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467716878 | Brenda Vidal | Counselor | 817 N Dixie Hwy, Pompano Beach, FL 33060-5621 | 2012-06-29 |
Street Address |
6441 JEFFERSON PIKE |
City | FREDERICK |
State | MD |
Zip Code | 21703-7039 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538773403 | Maryland Physical Therapy Services of Frederick, LLC | Speech-Language Pathologist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2020-09-08 |
1972869410 | Frederick Operating, LLC | Assisted Living Facility | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2012-04-10 |
1033481072 | Tranquillity At Fredericktowne | Assisted Living Facility | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2012-02-07 |
1053614792 | Shannon Carty | Physical Therapy Assistant | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2010-12-20 |
1972736536 | Elvia Kachenchai | Physical Therapy Assistant | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2009-08-31 |
1437380508 | Jean Louise Meissner | Physical Therapist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2009-08-06 |
1003945551 | Kelly R Hiltz | Occupational Therapist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2007-03-02 |
1861537102 | Debra K Capella | Physical Therapist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2007-02-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861902959 | Kenny Chen | Optometrist | 5283 Corporate Dr Ste 201, Frederick, MD 21703 | 2017-10-03 |
1578934550 | Barbara Tarlowski | Physical Therapy Assistant | 347 Ballenger Center Drive, Frederick, MD 21703 | 2015-10-15 |
1679958813 | Taiji Acupuncture Clinic | Community Based Residential Treatment Facility, Mental Illness | 1411 Bluewing Ct, Frederick, MD 21703 | 2015-07-29 |
1609283050 | Green Ridge Behavioral Health, LLC | Psychiatry & Neurology | 5216 Chairmans Court, Suite 102, Frederick, MD 21703 | 2014-07-17 |
1841597705 | Jennifer Anne Dye | Speech-Language Pathologist | 5312 Ballenger Creek Pike, Frederick, MD 21703 | 2011-02-11 |
1568794790 | Andersons Community Healthcare Services Inc | Nursing Care | 4727 Verdana Loop, Frederick, MD 21703 | 2010-02-15 |
1962672782 | Service Coordination Inc | Case Management | 5303 Spectrum Drive, Suite I, Frederick, MD 21703 | 2008-03-07 |
1396877189 | Health and Happiness LLC | Psychologist | 93 S Mccain Drive, Frederick, MD 21703 | 2007-03-09 |
1275629776 | Mary Bernadette Sheehy | Nurse Practitioner | Fmh Wellness Center 5500 Buckeystown Pike, Corpohs Prospect Plaza, Frederick, MD 21703 | 2006-10-04 |
1720185218 | Rea and Derick Inc P 1835 | Pharmacy | 5500 Buckeystown Pk Frcs Sct Key Mall, Frederick, MD 21703 | 2006-09-19 |
Find all providers in zip 21703 |
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 |
1487766788 | Jennifer L Carter | Psychologist | 97 S Mccain Dr # B, Frederick, MD 21703-6055 | 2006-08-31 |
1821025453 | Kevin Michael Holloway | Psychologist | 2053 Cohasset Ct, Frederick, MD 21702-9502 | 2006-06-27 |
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.