NPIMap

Organization Active NPI

Equanimity Integrated Behavioral Health & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Parkville, MD
National Provider Identifier
1013561976
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS LLC
Practice address
7500 Harford Rd Ste 1
Parkville, MD 21234-6900
Phone
(410) 240-1162
NPI assigned
Jul 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Reginald E Degrafenreid II, PMHNP-BC
Title
Owner/Ceo
Phone
(410) 240-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

7500 Harford Rd Ste 1
Parkville, MD 21234-6900

Mailing address

7500 Harford Rd Ste 1
Parkville, MD 21234-6900
Phone (410) 240-1162

Other names 1

  • Equanimity: IBHW Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1013561976",
    "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": "410-240-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HARFORD RD STE 1",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212346900",
            "telephone_number": "410-240-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "DEGRAFENREID",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "410-240-1162",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equanimity: IBHW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Equanimity: IBHW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.