MD TELEPSYCHIATRIC CENTER, L.L.C. (NPI# 1790393056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790393056 |
| Entity Type | Organization |
| Organization Name | MD TELEPSYCHIATRIC CENTER, L.L.C. |
| Practice Address |
13807 Clarkwood Ln Laurel MD 20707-9437 |
| Practice Telephone | 2403496300 |
| Practice Fax Number | 9796060062 |
| Mailing Telephone | 2403496300 |
| Mailing Fax Number | 9796060062 |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | DR. DR. ERNESTINE MBI ENOHMBI DNP, CRNP-FAMILY, CRNP-PMH (MANAGING PARTNER) |
| Authorized Official Telephone | 2403496300 |
| Authorized Official Credential | DNP, CRNP-PMH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| MD Telepsychiatric Center, L.L.C. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124654652 | Md Telepsychiatric Center, L.L.C. | Clinic/Center | 13807 Clarkwood Ln, Laurel, MD 20707-9437 | 2020-03-16 |
| Street Address |
13807 CLARKWOOD LN |
| City | LAUREL |
| State | MD |
| Zip Code | 20707-9437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154726404 | Ernestine Mbi Enohmbi | Nurse Practitioner | 13807 Clarkwood Ln, Laurel, MD 20707-9437 | 2014-10-29 |
| 1124654652 | Md Telepsychiatric Center, L.L.C. | Clinic/Center | 13807 Clarkwood Ln, Laurel, MD 20707-9437 | 2020-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157156 | Mini'imah Wilson | Social Worker | 15041 Cherrywood Dr, Laurel, MD 20707 | 2020-08-31 |
| 1548893985 | Ernest Freeman | Clinic/Center | 367 Main St., Laurel, Laurel, MD 20707 | 2020-02-13 |
| 1538701859 | Family Health and Wellness Clinic LLC | Clinic/Center | 324 Main St. #523, Laurel, MD 20707 | 2019-10-09 |
| 1467018226 | Leena Daniel | Nurse Practitioner | 13 C Street, Suite D, Laurel, MD 20707 | 2019-05-16 |
| 1538723143 | Florence Okojie | Nurse Practitioner | 13 C St Ste G, Laurel, MD 20707 | 2019-04-29 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1043709637 | Bk Behavioral Health Center | Behavior Technician | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707 | 2018-05-09 |
| 1053800839 | Bk Behaviorial Health Center | Substance Abuse Rehabilitation Facility | 14300 Cherry Lane Court, Suite 202-203, Laurel, MD 20707 | 2018-05-07 |
| 1316435795 | Laurel Pharmacy II LLC | Pharmacy | 14402 Baltimore Ave, Laurel, MD 20707 | 2018-05-01 |
| Find all providers in zip 20707 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053231 | All Is Well Therapeutic Services, LLC | Counselor | 3625 Sweetbush Trl, Laurel, MD 20724-2493 | 2020-11-06 |
| 1629678107 | Shamonique Driskell | Counselor | 14625 Baltimore Ave # 817, Laurel, MD 20707-4902 | 2020-10-26 |
| 1821624354 | Radiant Therapy, LLC | Counselor | 14201 Laurel Park Dr Ste 106, Laurel, MD 20707-5203 | 2020-03-16 |
| 1396380762 | Deana Weems | Counselor | 845 N 5th Ave, Laurel, MS 39440-2701 | 2019-11-08 |
| 1043851629 | Lorraine Marie Helferich | Counselor | 14800 4th St Apt 53a, Laurel, MD 20707-3712 | 2019-10-04 |
| 1174081913 | Darrius Humphrey | Counselor | 7625 Wood Lawn Boulevard, Medical Arts Building, Suite Ll50, Laurel, MD 20759 | 2019-03-12 |
| 1235601337 | Jernae Dickens | Counselor | 8602 Otter Creek Rd, Laurel, MD 20724-1984 | 2018-12-30 |
| 1205305786 | Nina Mitchell | Counselor | 196 Ertter Dr Apt 203, Laurel, MD 20724-2121 | 2018-11-14 |
| 1891279220 | Wendi Gordon | Counselor | 7310 Doddington Ct, Laurel, MD 20707-9420 | 2018-09-21 |
| 1194217091 | Matclinic Physicians Practice Group LLC | Counselor | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2018-06-06 |
| Find all providers in LAUREL | ||||
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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.