Mendelis Mental Health Center LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D0025586 Issued in MD

Legal business name

MENDELIS MENTAL HEALTH CENTER LLC

Practice address

11315 Pembrooke SQ Ste 112
Waldorf, MD 20603-4806

Phone

(301) 638-5001

Fax

(301) 638-5003

NPI assigned

Oct 6, 2006

Last updated

Nov 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter S Mendelis, MD

Title

Owner

Phone

(301) 638-5001

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1053408377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 PEMBROOKE SQ STE 112",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034806",
            "telephone_number": "301-638-5001",
            "fax_number": "301-638-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 PEMBROOKE SQ STE 112",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034806",
            "telephone_number": "301-638-5001",
            "fax_number": "301-638-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDELIS MENTAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "MENDELIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-638-5001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12909",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0025586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546610500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950006501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Melendez Olivero
• Leslie Melendez Olivero
• Jazshyla Denise Melon-Jacques
• Melwood
• Mendelis Mental Health Center
• Shafquat Meraj, M.D.
• Meridian Anesthesia Services, LLC
• Samantha Merritt, APRN
• Metro Healthcare Systems, Inc
• Metro Healthcare Systems, Inc

• Psychiatry Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.