MENTOR-MARYLAND (NPI# 1588190748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588190748 |
| Entity Type | Organization |
| Organization Name | MENTOR-MARYLAND |
| Practice Address |
1540 Caton Center Drive Halethorpe MD 21227 |
| Mailing Address |
5720 Executive Drive Catonsville MD 21228 |
| Practice Telephone | 4107374200 |
| Mailing Telephone | 4104554600 |
| Mailing Fax Number | 4104554659 |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |
| Authorized Official Name | MS. IVY SIMMONS (DIRECTOR OF OMHC) |
| Authorized Official Telephone | 4104554600 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MH-1757 | MD | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 056668 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023544285 | Mentor-maryland | Community/Behavioral Health | 4200 Forbes Boulevard, Suite 100, Lanham, MD 20706 | 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 |
1540 CATON CENTER DRIVE |
| City | HALETHORPE |
| State | MD |
| Zip Code | 21227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528622024 | Kim Conaway | Counselor | Regenerations Counseling Services, 1421 S. Canton Street, Baltimore, MD 21227 | 2019-04-30 |
| 1861974891 | Joan Lynn Indilisano | Occupational Therapist | 3320 Benson Avenue, Baltimore, MD 21227 | 2018-09-06 |
| 1821593161 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 1901 Sulphur Spring Rd Ste A, Baltimore, MD 21227 | 2018-03-28 |
| 1447779699 | Aja Williams | Registered Nurse | 3902 Annapolis Rd., Halethorpe, MD 21227 | 2017-09-19 |
| 1083084180 | Institute for Family Centered Services | Community/Behavioral Health | 1540 Caton Centered Drive, Suite F, Baltimore, MD 21227 | 2015-10-01 |
| 1174913677 | Wye Oak Clinic, Inc. | Marriage & Family Therapist | 1937 Lansdowne Rd, Halethorpe, MD 21227 | 2015-02-04 |
| 1588938237 | Ahmein Watson | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227 | 2012-02-28 |
| 1336442656 | Norah Orise Osian | Pharmacist | Rite Aid Pharmacy, 1400 Sulphur Spring Rd, Baltimore, MD 21227 | 2010-12-08 |
| 1366759623 | Een J Lee | Pharmacist | 1400 Sulphurspring Rd, Baltimore, MD 21227 | 2010-09-08 |
| 1780904847 | Emnet T Kflu | Counselor | 908 Francis Avenue, Halethorpe, MD 21227 | 2010-06-10 |
| Find all providers in zip 21227 | ||||
| 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 |
|---|---|---|---|---|
| 1750914172 | Grand Journey Behavioral Health Solutions, LLC | Community/Behavioral Health | 5515 Selma Ave Ste Aand2c, Halethorpe, MD 21227-2854 | 2020-02-13 |
| 1467936302 | Creative Psychological Health Services, LLC | Community/Behavioral Health | 203 Hillendale Ave, Halethorpe, MD 21227-3229 | 2018-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043127 | Ch Mh Services (md), LLC | Community/Behavioral Health | 12 W Montgomery St Ste 107, Baltimore, MD 21230-4490 | 2020-11-06 |
| 1154921682 | Neo Health Care Services, Inc. | Community/Behavioral Health | 110 Painters Mill Rd Ste 108, Owings Mills, MD 21117-5545 | 2020-10-26 |
| 1568062099 | Borderless Healthcare Services, LLC | Community/Behavioral Health | 1900 E Northern Pkwy Ste 308, Baltimore, MD 21239-2111 | 2020-10-26 |
| 1194324772 | Strength, Courage & Wisdom Behavioral Health | Community/Behavioral Health | 301 Main St Ste 2c, Reisterstown, MD 21136-1957 | 2020-10-23 |
| 1386243194 | Hands of Hope Therapeutic Services LLC | Community/Behavioral Health | 1123 State Route 3 N Ste 189, Gambrills, MD 21054-1715 | 2020-10-22 |
| 1568060630 | Miso Medical Center | Community/Behavioral Health | 14300 Cherry Lane Ct Ste 109, Laurel, MD 20707-4978 | 2020-10-12 |
| 1982211322 | Brenda Bivens Wilson | Community/Behavioral Health | 1726 Bolton St, Baltimore, MD 21217-4904 | 2020-09-29 |
| 1588270821 | Windward LLC | Community/Behavioral Health | 731 Old Herald Harbor Rd, Crownsville, MD 21032-1524 | 2020-09-22 |
| 1326652702 | Waller Psychotherapy, LLC | Community/Behavioral Health | 11007 Sweet Apple Ct, Upper Marlboro, MD 20772-7103 | 2020-09-03 |
| 1962016147 | One Step Closer Psychiatric Rehabilitation Program | Community/Behavioral Health | 8118 Harford Rd Ste E, Parkville, MD 21234-5725 | 2020-09-03 |
| Find all providers with the same taxonomy | ||||
| City | HALETHORPE |
| Zip Code | 21227 |
Please comment or provide details below to improve the information on MENTOR-MARYLAND.
| 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.