Healthcare Provider Details

I. General information

NPI: 1265265557
Provider Name (Legal Business Name): ELAINE GRAHAM DEARING PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 RIVERSIDE AVE
BALTIMORE MD
21230-4324
US

IV. Provider business mailing address

6501 N CHARLES ST OFC PJ121
TOWSON MD
21204-6819
US

V. Phone/Fax

Practice location:
  • Phone: 410-787-5392
  • Fax:
Mailing address:
  • Phone: 410-938-5216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07076
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number07076
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: