NPIMap

Organization Active NPI

The Mental Health Center of Western Maryland, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
National Provider Identifier
1104871946
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
THE MENTAL HEALTH CENTER OF WESTERN MARYLAND, INC.
Practice address
1180 Professional CT
Hagerstown, MD 21740-5852
Phone
(301) 791-3045
Fax
(240) 313-3071
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Kimberly L Holtz, MBA
Title
Executive Director
Phone
(301) 791-3045

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1180 Professional CT
Hagerstown, MD 21740-5852

Mailing address

1180 Professional CT
Hagerstown, MD 21740-5852
Phone (301) 791-3045

Other identifiers 8

IdentifierTypeStateIssuer
428100400MedicaidMD
428100419MedicaidMD
405342700MedicaidMD
281171500MedicaidMD
281171521MedicaidMD
428100420MedicaidMD
281171519MedicaidMD
621840700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000634 MD Part B Supplier - Clinic/Group Practice 9335040443 Receives reassigned benefits from 17 practitioners
Practice locations: Hagerstown, MD

National Provider Directory

National Provider Directory
Tax ID family
The Mental Health Center of Western Maryland Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19808 New Georges Creek Rd SW
Barton, MD 21521
Phone (301) 463-5002

93 E Main St
Frostburg, MD 21532
Phone (301) 689-5034

111 Weber Rd
Ste 2
Oakland, MD 21550
Phone (301) 334-9002

2008 Maryland Hwy
Oakland, MD 21550
Phone (301) 334-1686

69 Wolf Acres Dr
Ste C
Oakland, MD 21550
Phone (301) 533-2184

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1104871946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405852",
            "telephone_number": "301-791-3045",
            "fax_number": "240-313-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405852",
            "telephone_number": "301-791-3045",
            "fax_number": "240-313-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MENTAL HEALTH CENTER OF WESTERN MARYLAND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-791-3045",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428100400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428100419",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405342700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281171500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281171521",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428100420",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281171519",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621840700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.