Eshcol Behavioral Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ESHCOL BEHAVIORAL SERVICES LLC

Practice address

6223 Sweet Gum LN
Hanover, MD 21076-2127

Phone

(617) 461-3856

NPI assigned

Oct 8, 2021

Organization subpart

No

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

Authorized official

Name

Akhere Gwan, NP

Title

Psychiatric Nurse Practitioner

Phone

(617) 461-3856

Specialties & licenses 2

Addresses

Other names 1

• Eshcol Behavioral Services llc Former legal business name

Electronic endpoints 1

Practitioners 1

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

• Honorine Ezia Wanie, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Silver Spring, MD
  • NPI 1245625649
  NPD (past)

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1053073940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 SWEET GUM LN",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210762127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 SWEET GUM LN",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210762127",
            "telephone_number": "617-461-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESHCOL BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "GWAN",
        "authorized_official_first_name": "AKHERE",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "617-461-3856",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eshcol.behavioral.services@gmail.com",
            "affiliation": "N",
            "address_1": "6223 Sweet Gum Ln",
            "city": "Hanover",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210762127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eshcol Behavioral Services llc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Eshcol Behavioral Services llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Hanover, MD
• Providers in Hanover, 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 Nov 3, 2021; 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.