PRODUCTIVE LIVES MENTAL HEALTH, LLC (NPI# 1790208718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790208718 |
| Entity Type | Organization |
| Organization Name | PRODUCTIVE LIVES MENTAL HEALTH, LLC |
| Practice Address |
Randallstown Medical Center 5310 Old Court Rd Suite 308 Randallstown MD 21133 |
| Practice Telephone | (443) 415-1937 |
| Mailing Telephone | 4434151937 |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2017-07-21 |
| Authorized Official Name | MRS. TOWANNA MONIQUE MILLER-JOHNSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4434151937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
RANDALLSTOWN MEDICAL CENTER 5310 OLD COURT RD SUITE 308 |
| City | RANDALLSTOWN |
| State | MD |
| Zip Code | 21133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898313 | Olivia David | Registered Nurse | 3525 Liberty Resource Drive, Randallstown, MD 21133 | 2020-07-09 |
| 1366082547 | Jerry Njomgert Christopher | Home Health Aide | 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 | 2020-01-15 |
| 1487138913 | For Hope's Sake, LLC | Substance Abuse Rehabilitation Facility | 9905 Southhall Road, Randallstown, MD 21133 | 2018-09-20 |
| 1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
| 1235623968 | Away of Change Counseling Service, LLC | Counselor | 5310 Old Court Rd Ste 304, Randallstown, MD 21133 | 2018-06-16 |
| 1922503382 | Top Care Residential Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8607 Liberty Rd, Randallstown, MD 21133 | 2018-03-28 |
| 1497274880 | Yushika M Shepherd | In Home Supportive Care | 8911 Allenswood Rd, Randallstown, MD 21133 | 2017-09-17 |
| 1982136198 | Marla Rosanne Yee | Dentist | 5415 Old Court Road, Suite 01, Randallstown, MD 21133 | 2017-03-28 |
| 1598203549 | Traci Harris | Social Worker | 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 | 2017-02-09 |
| 1215321179 | Rita N Agugoesi | Social Worker | 4114 Brown Bark Circle, Randallstown, MD 21133 | 2015-03-27 |
| Find all providers in zip 21133 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209815 | Stride Forward Counseling LLC | Clinic/Center | 9 Newburg Ave Ste 102, Catonsville, MD 21228-5157 | 2020-09-15 |
| 1033724513 | S and S Properties 3 | Clinic/Center | 6122 Reisterstown Rd, Baltimore, MD 21215-3423 | 2020-09-11 |
| 1205440195 | Kevin Eugene Harvell | Clinic/Center | 3435 Greenmount Ave Ste 1, Baltimore, MD 21218-2942 | 2020-09-08 |
| 1528679834 | Erc Maryland | Clinic/Center | 7505 Osler Dr Ste 405, Towson, MD 21204-7739 | 2020-08-11 |
| 1245879386 | Anne Arundel County, Maryland | Clinic/Center | 839 Bestgate Rd Ste 300, Annapolis, MD 21401-3473 | 2020-01-06 |
| 1720627581 | Johns Hopkins Bayview Medical Center, Inc. | Clinic/Center | 5500 East Lombard Street, Room 1025, Baltimore, MD 21224 | 2019-12-27 |
| 1841847241 | Imperial Healthcare Services LLC | Clinic/Center | 547 Riverside Dr Ste A, Salisbury, MD 21801-5369 | 2019-08-20 |
| 1437714862 | Bolton Therapy & Wellness | Clinic/Center | 1534 Bolton St Ste 1, Baltimore, MD 21217-4203 | 2019-05-01 |
| 1497213581 | Pathways Inc | Clinic/Center | 2670 Crain Hwy Ste 300, Waldorf, MD 20601-2817 | 2019-03-07 |
| 1629553037 | Win Team, LLC | Clinic/Center | 7 Pleasant View Chrurch Road, Port Deposit, MD 21904 | 2018-10-02 |
| Find all providers with the same taxonomy | ||||
| City | RANDALLSTOWN |
| Zip Code | 21133 |
Please comment or provide details below to improve the information on PRODUCTIVE LIVES MENTAL HEALTH, LLC.
| 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.