Core Clinical Services
NPI 1649656943ActiveOrganization· Psychologist, Clinical· Timonium, MD
Psychologist, Clinical in Timonium, Maryland, registered in NPPES in August 2015. The authorized official on file is Marquerite Petranella Laban, PHD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1649656943 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 10, 2015 |
| Last updated in NPPES | Aug 8, 2023 |
| Certified by provider | Aug 8, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 05420 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MD) |
|---|
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