Magellan Health

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

LC3716 Issued in MD

Legal business name

MAGELLAN HEALTH

Practice address

6950 Columbia Gateway Dr
Columbia, MD 21046-2706

Phone

(800) 972-0716

NPI assigned

Nov 24, 2014

Organization subpart

Yes

Parent organization

IS MAGELLAN HEALTHCARE PROVIDER GROUPAs reported in NPPES

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

Authorized official

Name

David Goldman

Title

Clinical Director

Phone

(800) 972-0716

Specialties & licenses 1

Addresses

Part of

Magellan Healthcare Provider Group Inc

Locations

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1073910709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 COLUMBIA GATEWAY DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 COLUMBIA GATEWAY DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462706",
            "telephone_number": "800-972-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGELLAN HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IS MAGELLAN HEALTHCARE PROVIDER GROUP",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "800-972-0716"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MD",
            "license": "LC3716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolores Madiou, LCSW-C
• Sarah Madison
• Anthony Madonna
• Maes Counseling Corner
• Larissa Mafouo
• Magellan Healthcare Provider Group, Inc.
• Magellan Provider Services of Ca PC
• Magnet Health, LLC
• Christina Rene Magnotti, RN
• Euphemia Mah

• Point of Service in Columbia, MD
• Providers in Columbia, MD by specialty
• Point of Service in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.