Olivia Medoff

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2872 Issued in MD

Practice address

903 Brightseat Rd
Landover, MD 20785-4725

Phone

(301) 333-2980

NPI assigned

Sep 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1023624756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 BRIGHTSEAT RD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854725",
            "telephone_number": "301-333-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BRIGHTSEAT RD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854725",
            "telephone_number": "301-333-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOFF",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "2872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336470384",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Michelle McLean, LCPC, NCC
• Mark McNamara
• MD Medical Inc (Miriam Martin MD)
• Kristelle Meade
• Sade Arelia Mealy
• Ruth Mejia Deras
• Nicole Mekue Kamdem Epse Tamegne
• Lisa Mellynchuk
• Midori Melvin
• Michael Mendelson, DDS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Landover, MD
• Providers in Landover, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.