Organization Active NPI

Omj & Associates LLC

  • Mental Health Counselor
  • Edgewood, MD
National Provider Identifier
1114428075
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17112 Issued in MD
Legal business name
OMJ & ASSOCIATES LLC
Practice address
1308 Business Center Way Ste 101
Edgewood, MD 21040-1504
Phone
(443) 271-5021
NPI assigned
Feb 26, 2018
Last updated
Feb 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Authorized official

Name
Ms. Tymeka Dawan Jones, LCSW-CNPI 1053731240
Title
Owner
Phone
(443) 271-5021

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 17112 MD Primary

Addresses

Primary practice location

1308 Business Center Way Ste 101
Edgewood, MD 21040-1504

Mailing address

5105 Hillburn Ave
Baltimore, MD 21206-4130
Phone (443) 271-5021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200930000831 MD Part B Supplier - Clinic/Group Practice 0143649855 Receives reassigned benefits from 1 practitioner
Practice locations: Edgewood, MD

National Provider Directory

National Provider Directory

Locations

1308 Business Center Way
Ste 101
Edgewood, MD 21040
Phone (443) 271-5021

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": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1114428075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 HILLBURN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212064130",
            "telephone_number": "443-271-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BUSINESS CENTER WAY STE 101",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401504",
            "telephone_number": "443-271-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMJ & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TYMEKA",
        "authorized_official_middle_name": "DAWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-271-5021",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "17112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.