NPIMap

Organization Active NPI

Affiliated Sante Group

  • Psychologist
  • Lanham, MD
National Provider Identifier
1013348267
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
AFFILIATED SANTE GROUP
Practice address
4355 Nicole Dr
Lanham, MD 20706-4349
Phone
(301) 429-2171
NPI assigned
Dec 12, 2013
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Fred Chanteau
Title
Ceo
Phone
(301) 572-6585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

4355 Nicole Dr
Lanham, MD 20706-4349

Mailing address

12200 Tech Rd
Suite 330
Silver Spring, MD 20904-1983
Phone (301) 787-5692

Other identifiers 1

IdentifierTypeStateIssuer
422027700MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Affiliated Sante GRP18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

4355 Nicole Dr
Lanham, MD 20706
Phone (301) 429-2171

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1013348267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 TECH RD",
            "address_2": "SUITE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041983",
            "telephone_number": "301-787-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 NICOLE DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064349",
            "telephone_number": "301-429-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED SANTE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "CHANTEAU",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-572-6585"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422027700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.