Individual provider Active NPI

Liam Donovan, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1083452502
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R245773 Issued in MD
Practice address
7452 Baltimore Annapolis Blvd # 102
Glen Burnie, MD 21061-3547
Phone
(410) 766-1544
NPI assigned
Jul 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R245773 MD Primary

Addresses

Primary practice location

7452 Baltimore Annapolis Blvd # 102
Glen Burnie, MD 21061-3547

Mailing address

7452 Baltimore Annapolis Blvd # 102
Glen Burnie, MD 21061-3547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240817000030 MD Practitioner - Nurse Practitioner 9931647294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holistic Approach Mental Health,LLCGroup PAC ID 3779711973, 4 clinicians

Practice addresses (Care Compare)

7452 Baltimore Annapolis Blvd
Suite 107
Glen Burnie, MD 21061-3547
Phone (410) 766-1544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R245773MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Approach Mental Health, LLC CurrentSince Aug 5, 2024 Accepting new patients

Locations

7452 Baltimore Annapolis Blvd
Ste 107
Glen Burnie, MD 21061
Phone (410) 766-1544

7452 Baltimore Annapolis Blvd
#102
Glen Burnie, MD 21061
Phone (410) 766-1544

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1083452502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7452 BALTIMORE ANNAPOLIS BLVD # 102",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7452 BALTIMORE ANNAPOLIS BLVD # 102",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613547",
            "telephone_number": "410-766-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "LIAM",
        "name_prefix": "Dr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R245773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.