Healthcare Provider Details

I. General information

NPI: 1669396131
Provider Name (Legal Business Name): DELANEY J PUTT M.A., C.A.S., NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10910 CLARKSVILLE PIKE
ELLICOTT CITY MD
21042-6106
US

IV. Provider business mailing address

8930 STANFORD BLVD # 201
COLUMBIA MD
21045-5805
US

V. Phone/Fax

Practice location:
  • Phone: 410-313-6600
  • Fax:
Mailing address:
  • Phone: 410-313-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: