Healthcare Provider Details

I. General information

NPI: 1972418911
Provider Name (Legal Business Name): ELAINE DEARING PSYCHOLOGIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1272 RIVERSIDE AVE
BALTIMORE MD
21230-4324
US

IV. Provider business mailing address

1272 RIVERSIDE AVE
BALTIMORE MD
21230-4324
US

V. Phone/Fax

Practice location:
  • Phone: 817-907-4254
  • Fax:
Mailing address:
  • Phone: 817-907-4254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELAINE GRAHAM DEARING
Title or Position: OWNER
Credential: PSY.D.
Phone: 817-907-4254