Affiliated Sante Group
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Silver Spring, MD
NPI 1083720569 · NPPES record last updated Sep 16, 2019
Key facts
- NPI
- 1083720569
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- AFFILIATED SANTE GROUP
- Practice address
- 1400 Spring St Ste 100
Silver Spring, MD 20910-2751 - Phone
- (301) 589-2303
- Fax
- (301) 585-2965
- NPI assigned
- Aug 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Steven Sahm
- Title
- Billing Manager
- Phone
- (301) 572-6585
Corporate family (same tax ID) 17
Practitioners 49
-
Nina Caballero, LCPC
-
Adesuwa Izevbigie, LCPC
-
Odelia Muir, LCSW-C, LICSW
-
Lorraine Ellen Sakaris, LCPC
-
Evan Timberlake, LCSW-C
-
Yasaman Alavi, LCPC
-
Kimberly Cecelia Ward, LCSW-C, LICSW
-
Sandor Parente Orban, MSW, LGSW
-
Dwight L Donesky, M.D.
-
Megan Saulsbury, LCSW-C
-
Surriya Azam, M.D.
-
Memunatu Bangura, M.D.
-
Russell W Carrington, LCSW C
-
Shemica Cole, LCSW-C
-
John S. Daken, M.D.
-
Deborah Lynn Dallam, M.D.
-
Carolyn G Dawkins, LCSWC
-
Dida K. Ganjoo, M.D.
-
Sheila N Gart, LCSWC
-
Diane Beck Goldsmith, LCSWC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040402000456 | MD | Part B Supplier - Clinic/Group Practice | 4385546639 |
Receives reassigned benefits from 1 practitioner Practice locations: Silver Spring, MD |
| O20040429000842 | DC | Part B Supplier - Clinic/Group Practice | 4385546639 |
Receives reassigned benefits from 13 practitioners Practice locations: Silver Spring, MD |
National Provider Directory
- Tax ID family
- Asg
Locations
1400 Spring St
Ste 100
Silver Spring, MD 20910
Phone (301) 589-2303
7961 Eastern Ave
Silver Spring, MD 20910
Phone (301) 589-2303
12200 Tech Rd
Silver Spring, MD 20904
Phone 3013408339213
7961 Eastern Ave
Fl 1
Silver Spring, MD 20910
Phone (301) 589-2303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
1400 Spring St Ste 100
Silver Spring, MD 20910-2751
Mailing address
12200 Tech Rd Ste 330
Silver Spring, MD 20904-1913
Phone (301) 572-6585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 352850200 | Medicaid | MD | |
| 340671700 | Medicaid | MD | |
| 3406717000 | Medicaid | MD |
Other providers in Silver Spring, MD
- Eskinder Afework
- Biniam Yohannes Afeworki
- Stephanie Ann Affeldt
- Affiliated Pet Systems LLC
- Affiliated Sante Group
- Affinity Community Development, Inc.
- Affinity Sports & Rehabilitaion Physical Therapy
- Affinity Sports & Rehabilitation
- Affordable & Knowledgeable Services Inc
- Lekie Abebe Afine
All providers in Silver Spring, MD · Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.