MY COVENANT PLACE (NPI# 1164853669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164853669 |
| Entity Type | Organization |
| Organization Name | MY COVENANT PLACE |
| Practice Address |
1300 Mercantile Ln Suite 123 Largo MD 20774-5327 |
| Mailing Address |
1300 Mercantile Lane Suite 123 Largo MD 20774 |
| Practice Telephone | 3015777307 |
| Practice Fax Number | 3014760076 |
| Mailing Telephone | 3015777307 |
| Mailing Fax Number | 3014760076 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |
| Authorized Official Name | MS. LATISHA CARTER (CEO) |
| Authorized Official Telephone | 3015777307 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MD | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MY COVENANT PLACE INC. | 9500 Arena Dr Ste 104, Largo, MD 20774-3700 |
| Street Address |
1300 MERCANTILE LN SUITE 123 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522745 | Health Choice By Grace, LLC | Clinic/Center | 1300 Mercantile Ln, Largo, MD 20774-5327 | 2019-08-06 |
| 1104306414 | Curtis Tommy Clair Jr. | Counselor | 1300 Mercantile Ln, Largo, MD 20774-5327 | 2018-08-16 |
| 1609374610 | Medical One Solutions, Inc | Nursing Care | 1300 Mercantile Ln, 100k, Largo, MD 20774-5327 | 2018-01-24 |
| 1134662034 | Brown'scounseling & Therapeutic Services, LLC | Counselor | 1300 Mercantile Ln, Suite 141-d, Largo, MD 20774-5327 | 2016-11-24 |
| 1952756587 | Margo Renee Hammond | Social Worker | 1300 Mercantile Ln, Suite 129-35, Largo, MD 20774-5327 | 2016-05-02 |
| 1891157962 | Brandon Moseley | Counselor | 1300 Mercantile Ln, Largo, MD 20774-5327 | 2016-03-28 |
| 1205208485 | Safe Harbor Christian Counseling | Psychologist | 1300 Mercantile Ln, Largo, MD 20774-5327 | 2015-10-27 |
| 1417344896 | Community Counseling & Mentoring Services, Inc. | Clinic/Center | 1300 Mercantile Ln, Suite 208, Largo, MD 20774-5327 | 2015-04-23 |
| 1366871907 | Salim Bilal Edwards | Counselor | 1300 Mercantile Ln, 139-r, Largo, MD 20774-5327 | 2013-11-04 |
| 1285061754 | Lauri R Preston | Social Worker | 1300 Mercantile Ln, Suite 141-d, Largo, MD 20774-5327 | 2013-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| 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 |
|---|---|---|---|---|
| 1417459413 | The Solace Center, LLC | Community/Behavioral Health | 9701 Apollo Dr Ste 461, Largo, MD 20774-6701 | 2018-03-06 |
| 1962881821 | Building Blocks Therapy, Pllc | Community/Behavioral Health | 1301 Seminole Blvd Building A Suite 103, Largo, FL 33770 | 2015-05-26 |
| 1598974818 | Gulf Coast Jewish Family Services | Community/Behavioral Health | 6451 126th Ave Ste 300, Largo, FL 33773-1866 | 2007-05-22 |
| 1932268174 | Operation Par Inc | Community/Behavioral Health | 13800 66th St, Largo, FL 33771-4909 | 2006-12-06 |
| 1356958169 | Trh Family Solutions LLC | Community/Behavioral Health | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2020-09-25 |
| 1700419892 | Qci Behavioral Health Consulting Group, LLC | Community/Behavioral Health | 9475 Lottsford Rd, Largo, MD 20774-5357 | 2020-02-17 |
| 1205308731 | Transitions Counseling and Mentoring Services Inc. | Community/Behavioral Health | 9500 Medical Center Drive, Suite 432, Largo, MD 20774 | 2018-12-21 |
| 1457864290 | Anew Therapeutic Services LLC | Community/Behavioral Health | 9500 Arena Dr Ste 460c, Largo, MD 20774-3755 | 2017-11-15 |
| 1205389921 | Kamden Counseling & Consulting Group, LLC | Community/Behavioral Health | 9701 Apollo Dr, Suite 301, Largo, MD 20774-4783 | 2016-07-28 |
| 1639572738 | Cronin Counseling Service | Community/Behavioral Health | 10225 Ulmerton Rd, Suite 9c, Largo, FL 33771-3538 | 2014-10-02 |
| Find all providers in LARGO | ||||
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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.