NPIMap

Organization Active NPI

Kingdom Behavioral Health LLC

  • Psychiatry Physician
  • Hagerstown, MD
National Provider Identifier
1023627510
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KINGDOM BEHAVIORAL HEALTH LLC
Practice address
5 Public SQ Ste 213
Hagerstown, MD 21740-5599
Phone
(443) 968-1153
NPI assigned
Jul 30, 2020
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Mr. Taofeek Adekunle BelloNPI 1730603127
Title
President/Ceo
Phone
(443) 968-1153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

5 Public SQ Ste 213
Hagerstown, MD 21740-5599

Mailing address

5 Public SQ Ste 213
Hagerstown, MD 21740-5599
Phone (443) 968-1153

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1023627510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PUBLIC SQ STE 213",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405599",
            "telephone_number": "443-968-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PUBLIC SQ STE 213",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405599",
            "telephone_number": "443-968-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "BELLO",
        "authorized_official_first_name": "TAOFEEK",
        "authorized_official_middle_name": "ADEKUNLE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "443-968-1153",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.