Active NPI
Equanimity Integrated Behavioral Health & Wellness
- Psychiatric/Mental Health Nurse Practitioner
- Towson, MD
National Provider Identifier
1003644030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS
- Doing business as
- Equanimity Integrated Behavioral Health & Wellness LLC
- Practice address
- 1001 Cromwell Bridge Rd Ste 100
Towson, MD 21286-3329 - Phone
- (443) 251-2100
- Fax
- (240) 241-6360
- NPI assigned
- Jul 22, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Reginald Eugene Degrafenreid Jr., CRNP, PMHNP-BC, FNP-
- Title
- Owner
- Phone
- (443) 708-8139
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
1001 Cromwell Bridge Rd Ste 100
Towson, MD 21286-3329
Mailing address
7500 Harford Rd Ste 1
Parkville, MD 21234-6900
Phone (443) 251-2100
Other names 1
- Equanimity Integrated Behavioral Health & Wellness LLC
National Provider Directory
National Provider Directory- Tax ID family
- Equanimity Integrated Behavioral Health Wellness LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Parkville, MD
- NPI 1235888157
-
- Community/Behavioral Health Agency
- Parkville, MD
- NPI 1982345997
Locations
1001 Cromwell Bridge Rd
Ste 100
Towson, MD 21286
Phone (410) 583-0123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721606400000",
"number": "1003644030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 HARFORD RD STE 1",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212346900",
"telephone_number": "443-251-2100",
"fax_number": "240-241-6360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 CROMWELL BRIDGE RD STE 100",
"city": "TOWSON",
"state": "MD",
"postal_code": "212863329",
"telephone_number": "443-251-2100",
"fax_number": "240-241-6360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A",
"authorized_official_last_name": "DEGRAFENREID",
"authorized_official_first_name": "REGINALD",
"authorized_official_middle_name": "EUGENE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "443-708-8139",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "CRNP, PMHNP-BC, FNP-"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Equanimity Integrated Behavioral Health & Wellness LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.