MS. JUDY ANN TYSON PH.D.
NPI 1720086564
Psychologist in Gaithersburg, MD

Active since July 13, 2005PECOS Enrolled
8915 SHADY GROVE CT, GAITHERSBURG, MD 20877(301) 963-0060(301) 258-8858 Get Directions Write a Review

NPPES record last updated: March 24, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Judy Ann Tyson Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JUDY ANN TYSON PH.D. (NPI 1720086564) is an individual psychologist in Gaithersburg, Maryland, licensed in Maryland (1966) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720086564
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. JUDY ANN TYSONCredential: PH.D.
Location Address8915 SHADY GROVE CTGaithersburg, MD 20877-1308
Mailing Address8915 Shady Grove CtGaithersburg, MD 20877-1308 · (301) 963-0060 · Fax (301) 258-8858
Fax(301) 258-8858
Sole ProprietorYes
Enumeration DateJuly 13, 2005
Last NPPES UpdateMarch 24, 2016
NPI 1720086564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MD · 1966
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

8915 SHADY GROVE CT, Gaithersburg, MD 20877

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Judy Ann Tyson Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2016 through July 1, 2026.

Opt-Out Effective DateJuly 1, 2016
Opt-Out In Effect ThroughJuly 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
8915 SHADY GROVE CT
GAITHERSBURG, MD 20877
Psychiatry & Neurology (Psychiatry)
8915 SHADY GROVE CT
GAITHERSBURG, MD 20877
Clinical Nurse Specialist (Psychiatric/Mental Health)
8915 SHADY GROVE CT
GAITHERSBURG, MD 20877
Registered Nurse (Psychiatric/Mental Health)
8915 SHADY GROVE CT
GAITHERSBURG, MD 20877
Psychologist
8915 SHADY GROVE CT
GAITHERSBURG, MD 20877

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720086564, enumerated as an "individual" on July 13, 2005.

The provider is located at 8915 SHADY GROVE CT GAITHERSBURG, MD 20877 and the phone number is (301) 963-0060.

Psychologist with taxonomy code 103T00000X.