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DR. DONNA LORRAINE TICKNOR M.D.
NPI 1720131295
Psychiatry & Neurology - Psychiatry in Glen Burnie, MD

Active since January 19, 2007Opted out of Medicare · through Jan 9, 2027
1600 CRAIN HWY S STE 608, GLEN BURNIE, MD 21061(410) 205-9205(619) 268-5973 Get Directions Write a Review

NPPES record last updated: May 15, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 15, 2024, Jul 8, 2019, Jan 31, 2019 (3 updates tracked since 2019).

About Dr. Donna Lorraine Ticknor M.d. NPPES

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

DR. DONNA LORRAINE TICKNOR M.D. (NPI 1720131295) is an individual psychiatry provider in Glen Burnie, Maryland, licensed in Maryland (D0086372) and active in the NPI registry since January 2007. She has opted out of Medicare through January 9, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1720131295
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameDR. DONNA LORRAINE TICKNORCredential: M.D.
Location Address1600 CRAIN HWY S STE 608Glen Burnie, MD 21061-6442
Mailing Address408 Kathe CtRiva, MD 21140-1312 · (301) 996-2949 · Fax (619) 268-5973
Phone(410) 205-9205
Fax(619) 268-5973
Sole ProprietorYes
Enumeration DateJanuary 19, 2007
Last NPPES UpdateMay 15, 20243 updates tracked since enumeration
NPPES CertifiedMay 15, 2024
✔ NPI 1720131295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in MD · D0086372✔ Licensed in DC · MD32440
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1600 CRAIN HWY S STE 608, Glen Burnie, MD 21061
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Donna Lorraine Ticknor M.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 January 9, 2019 through January 9, 2027.

Opt-Out Effective DateJanuary 9, 2019
Opt-Out In Effect ThroughJanuary 9, 2027Opt-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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21061 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$183.44 typical visit price
range $60.73 – $183.44
Typical copayment $45.86 (range $15.18 – $45.86)
Most-billed visit code 99205
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LINDSEY WEST LCSW
Social Worker (Clinical)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
SOUTH RIVER PSYCHIATRIC SERVICES, LLC
Psychiatry & Neurology (Psychiatry)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (410) 205-9205
KARAN KAPOOR LMSW
Social Worker
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
GILA CHAMAMA LGPC
Psychologist (Counseling)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
AVIGAYIL RABI LCSW
Social Worker
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donna Ticknor's NPI number?

The NPI number for Donna Ticknor is 1720131295. It was assigned to this individual provider in the NPPES registry on January 19, 2007.

Where is Donna Ticknor located?

Donna Ticknor practices at 1600 Crain Hwy S Ste 608, Glen Burnie, MD 21061. The listed phone number is (410) 205-9205.

What is Donna Ticknor's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Donna Ticknor enrolled in Medicare?

No. Donna Ticknor has opted out of Medicare through January 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Donna Ticknor was last updated on May 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.