Vivian Imo Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

VIVIAN IMO PSYCHIATRY, LLC

Practice address

1412 Crain Hwy N Ste 6B
Glen Burnie, MD 21061-9306

Phone

(301) 337-6669

Fax

(301) 477-8931

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Vivian Adaeze Imo, DNP, CRNP-PMH

Title

Owner

Phone

(301) 821-7488

Specialties & licenses 1

Addresses

Other names 1

• VIPsychiatry Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1013775014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 CRAIN HWY N STE 6B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619306",
            "telephone_number": "301-377-6669",
            "fax_number": "301-477-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 CRAIN HWY N STE 6B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619306",
            "telephone_number": "301-337-6669",
            "fax_number": "301-477-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIAN IMO PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "IMO",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "ADAEZE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-821-7488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CRNP-PMH"
    },
    "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": "VIPsychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VIPsychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.