NPIMap

Organization Active NPI

Lifespan Behavioral Health Services PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
National Provider Identifier
1003562299
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFESPAN BEHAVIORAL HEALTH SERVICES PC
Practice address
1003 W 7TH St Ste 200
Frederick, MD 21701-4106
Phone
(301) 245-6300
NPI assigned
Feb 25, 2022
Organization subpart
Yes
Parent organization
LIFESPAN BEHAVIORAL HEALTH SERVICES PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joshua SussalNPI 1922212174
Title
MD/Ceo
Phone
(301) 982-3437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1003 W 7TH St Ste 200
Frederick, MD 21701-4106

Mailing address

1003 W 7TH St Ste 200
Frederick, MD 21701-4106
Phone (301) 245-6300

Other names 1

  • Lifespan Behavioral Health Services PC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Lifespan Behavioral Health4 organizations share this tax ID, including this one
Part of
Lifespan Behavioral Health

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1003562299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W 7TH ST STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014106",
            "telephone_number": "301-245-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W 7TH ST STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014106",
            "telephone_number": "301-245-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN BEHAVIORAL HEALTH SERVICES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN BEHAVIORAL HEALTH SERVICES PC",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "SUSSAL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "301-982-3437"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifespan Behavioral Health Services PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.