Organization Active NPI

BH Wellness LLC

  • Clinical Psychologist
  • Bel Air, MD
National Provider Identifier
1104675123
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BH WELLNESS LLC
Practice address
260 Gateway Dr Ste 4C
Bel Air, MD 21014-4168
Phone
(888) 499-8909
NPI assigned
May 13, 2024
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Dr. Lyubov Popivker, PSYDNPI 1215256664
Title
Clinical Psychologist
Phone
(888) 499-8909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

260 Gateway Dr Ste 4C
Bel Air, MD 21014-4168

Mailing address

260 Gateway Dr Ste 4C
Bel Air, MD 21014-4168
Phone (888) 499-8909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240910003741 MD Part B Supplier - Clinic/Group Practice 2769922384 Receives reassigned benefits from 1 practitioner
Practice locations: Bel Air, MD

National Provider Directory

National Provider Directory

Locations

260 Gateway Dr
Ste 4C
Bel Air, MD 21014
Phone (888) 499-8909

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1104675123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR STE 4C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144168",
            "telephone_number": "888-499-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR STE 4C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144168",
            "telephone_number": "888-499-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "POPIVKER",
        "authorized_official_first_name": "LYUBOV",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "888-499-8909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.