MENTOR-MARYLAND


Address: 4200 Forbes Boulevard, Suite 100, Lanham, MD 20706
Phone: 3014593057

MENTOR-MARYLAND (NPI# 1023544285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health MH-2278 MD Agencies

Other Provider Identifier

State Issuer Identifier Type Code
MD 056668 05

Other Provider IDs and Locations

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

Office Location

Street Address 4200 FORBES BOULEVARD
SUITE 100
City LANHAM
State MD
Zip Code 20706

Providers in the same zip code

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 Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City LANHAM
Zip Code 20706

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Dataset Information

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.

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