NPIMap

Organization Active NPI

Integrative Behavioral Health,LLC

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1033738927
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INTEGRATIVE BEHAVIORAL HEALTH,LLC
Practice address
120 Sister Pierre Dr Ste 205
Towson, MD 21204-7525
Phone
(443) 288-0098
NPI assigned
Apr 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Mr. Darrell Jamison, LCSW-CNPI 1477024883
Title
Ceo / President
Phone
(443) 765-1458

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

120 Sister Pierre Dr Ste 205
Towson, MD 21204-7525

Mailing address

120 Sister Pierre Dr Ste 205
Towson, MD 21204-7525
Phone (443) 288-0098

Other practice location 1

2519 Maryland Ave Ste 100
Baltimore, MD 21218-4995
Phone (443) 765-1458

Other names 1

  • IBH Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL direct Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200511000026 MD Part B Supplier - Clinic/Group Practice 2961833884 Receives reassigned benefits from 4 practitioners
Practice locations: Baltimore, MD; Towson, MD

National Provider Directory

National Provider Directory

Locations

2519 Maryland Ave
Ste 100
Baltimore, MD 21218
Phone (443) 288-0098

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1033738927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 205",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047525",
            "telephone_number": "443-288-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 205",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047525",
            "telephone_number": "443-288-0098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2519 Maryland Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212184995",
            "country_code": "US",
            "telephone_number": "443-765-1458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATIVE BEHAVIORAL HEALTH,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-11",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "CEO / PRESIDENT",
        "authorized_official_telephone_number": "443-765-1458",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "direct",
            "affiliation": "N",
            "endpointDescription": "Encrypted",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2519 Maryland Ave Ste 100",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212184995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "IBH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IBH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.