MENTOR-MARYLAND (NPI# 1023544285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023544285 |
| Entity Type | Organization |
| Organization Name | MENTOR-MARYLAND |
| Practice Address |
4200 Forbes Boulevard Suite 100 Lanham MD 20706 |
| Mailing Address |
5720 Executive Drive Catonsville MD 21228 |
| Practice Telephone | 3014593057 |
| Mailing Telephone | 4104554600 |
| Mailing Fax Number | 4104554659 |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |
| Authorized Official Name | DR. CAROL IVY SIMMONS (DIRECTOR OMHC) |
| Authorized Official Telephone | 4104554600 |
| Authorized Official Credential | PH.D., LCSW-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MH-2278 | MD | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 056668 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
| 1750817912 | Mentor-maryland | Community/Behavioral Health | 620 West Naylor Mill Road, Suite A-f, Salisbury, MD 21801 | 2017-05-10 |
| 1104352368 | Mentor-maryland | Community/Behavioral Health | 5970 Frederick Crossing Lane, #202, Frederick, MD 21704 | 2017-05-10 |
| Street Address |
4200 FORBES BOULEVARD SUITE 100 |
| City | LANHAM |
| State | MD |
| Zip Code | 20706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046775 | Ayesha Tappin | Occupational Therapist | 4200 Parliament Pl. Ste 550, Lanham, MD 20706 | 2019-04-24 |
| 1790240646 | Himabindu Gangavarapu Vinodrao | Nurse Practitioner | 8118, Good Luck Road, Lanhham, MD 20706 | 2019-02-05 |
| 1538644943 | Win Team, LLC | Clinic/Center | 10001 Derekwood Lane, Suite 210, Lanham, MD 20706 | 2018-10-02 |
| 1558846394 | Brieana Moore | Behavioral Analyst | 4551 Parliament Place Suite A, Lanham, MD 20706 | 2018-09-27 |
| 1225511553 | Melvis Afanwi Chi | Home Health Aide | 9861 Goodluck Rd, T1, Lanham, MD 20706 | 2018-09-12 |
| 1346722766 | Elsie Clarke | Nurse Practitioner | 9470 Annapolis Road Suite 311, Lanham, MD 20706 | 2018-09-01 |
| 1821576141 | Amie Da Silva | Nurse Practitioner | 5724 Edge Avenue, Lanham, MD 20706 | 2018-07-30 |
| 1033697313 | Iyadunni Omolara Olukorede | Home Health Aide | 9789 Good Luck Rd Apt 9, Lanham, MD 20706 | 2018-07-30 |
| 1447741459 | A Step Ahead Preventive and Holistic Wellness Center LLC | Psychologist | 4500 Forbes Blvd # 200-w12, Lanham, MD 20706 | 2018-05-24 |
| 1902394398 | Ezekiel Kelechukwu Nwafor | Home Health Aide | 5447 85th Ave Apt 202, Lanham, MD 20706 | 2018-05-01 |
| Find all providers in zip 20706 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080919 | Kathleen Young & Associates LLC | Community/Behavioral Health | 4200 Forbes Blvd Ste 104, Lanham, MD 20706-4872 | 2020-07-13 |
| 1659918522 | Family Services, Inc. | Community/Behavioral Health | 7401 Forbes Blvd Ste F, Lanham, MD 20706-2261 | 2019-12-10 |
| 1518504067 | Allen-ayuk Behavioral Health Center | Community/Behavioral Health | 7404 Executive Pl Ste 420, Lanham, MD 20706-2268 | 2019-12-03 |
| 1891278610 | Win Team, LLC | Community/Behavioral Health | 10001 Derekwood Ln Ste 210, Lanham, MD 20706-4865 | 2018-09-07 |
| 1265954226 | Community Therapeutic Center,inc | Community/Behavioral Health | 4640 Forbes Blvd Ste 310, Lanham, MD 20706-4889 | 2017-07-12 |
| 1720442684 | Btst Services LLC | Community/Behavioral Health | 4303 Forbes Blvd, Lanham, MD 20706-4333 | 2016-04-07 |
| 1396080594 | Btst Services LLC | Community/Behavioral Health | 9701 Philadelphia Ct, Suite R, Lanham, MD 20706-4400 | 2012-11-29 |
| 1639443963 | Family Advocacy Network, Inc. | Community/Behavioral Health | 8601 Martin Luther King Jr Hwy Ste 4, Lanham, MD 20706-1560 | 2012-03-05 |
| 1144592908 | Regenerations Counseling Services Inc | Community/Behavioral Health | 4600 Forbes Blvd, Suite 202, Lanham, MD 20706-4312 | 2012-02-08 |
| 1487983102 | Affiliated Sante Group | Community/Behavioral Health | 4355 Nicole Dr, Lanham, MD 20706-4349 | 2009-12-08 |
| Find all providers in LANHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.