MENTOR-MARYLAND (NPI# 1750817912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750817912 |
Entity Type | Organization |
Organization Name | MENTOR-MARYLAND |
Practice Address |
620 West Naylor Mill Road Suite A-f Salisbury MD 21801 |
Mailing Address |
5720 Executive Drive Catonsville MD 21228 |
Practice Telephone | 4105485921 |
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-1792 | 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 |
1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
1104352368 | Mentor-maryland | Community/Behavioral Health | 5970 Frederick Crossing Lane, #202, Frederick, MD 21704 | 2017-05-10 |
Street Address |
620 WEST NAYLOR MILL ROAD SUITE A-F |
City | SALISBURY |
State | MD |
Zip Code | 21801 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
Find all providers in zip 21801 |
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 |
---|---|---|---|---|
1720692833 | Tgh Phase 2 | Community/Behavioral Health | 1121 Old Concord Rd Ste 14, Salisbury, NC 28146-1473 | 2020-09-04 |
1326694217 | Ifcs of Maryland, Inc. A/k/a Institute for Family Centered Services, I | Community/Behavioral Health | 2326 Goddard Pkwy Ste D, Salisbury, MD 21801-1126 | 2019-08-15 |
1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
1801392071 | Tgh Behavioral Health Services Inc. | Community/Behavioral Health | 4030 Woodleaf Rd, Salisbury, NC 28147-7771 | 2018-04-04 |
1336655547 | Focus Point Solutions LLC | Community/Behavioral Health | 803 N Salisbury Blvd Ste 2200, Salisbury, MD 21801-3657 | 2017-12-26 |
1447775804 | Monarch | Community/Behavioral Health | 2602 Stokes Ferry Rd, Salisbury, NC 28146-2211 | 2017-08-07 |
1316473556 | Go-getters, Inc. | Community/Behavioral Health | 108 E Lehigh Ave, Salisbury, MD 21801-4173 | 2017-05-09 |
1528594744 | Go-getters, Inc. | Community/Behavioral Health | 704 N. Division St., Salisbury, MD 21801 | 2017-05-09 |
1245781582 | Go-getters, Inc. | Community/Behavioral Health | 704 N. Division Street, Salisbury, MD 21801 | 2016-10-21 |
1104374156 | Tgh Behavior of New Jersey | Community/Behavioral Health | 2616 Old Wilkesboro Rd, Salisbury, NC 28144-3073 | 2016-09-20 |
Find all providers in SALISBURY |
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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.