NPIMap

Organization Active NPI

Family Educational Support Services

  • Adolescent and Children Mental Health Clinic/Center
  • Bowie, MD
National Provider Identifier
1114482247
Registry record updated Feb 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
FAMILY EDUCATIONAL SUPPORT SERVICES
Practice address
4201 Northview Dr Ste 404
Bowie, MD 20716-2664
Phone
(301) 448-6939
NPI assigned
Feb 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2019

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

Authorized official

Name
Phyllis Randle, LICSW-C
Title
Chief Executive Officer
Phone
(301) 448-6939

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

4201 Northview Dr Ste 404
Bowie, MD 20716-2664

Mailing address

4201 Northview Dr Ste 404
Bowie, MD 20716-2664
Phone (301) 448-6939

National Provider Directory

National Provider Directory

Locations

4201 Northview Dr
Ste 404
Bowie, MD 20716
Phone (301) 448-6939

NPI Registry JSON

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

{
    "created_epoch": "1549152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549152000000",
    "number": "1114482247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 NORTHVIEW DR STE 404",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162664",
            "telephone_number": "301-448-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 NORTHVIEW DR STE 404",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162664",
            "telephone_number": "301-448-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EDUCATIONAL SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-03",
        "last_updated": "2019-02-03",
        "status": "A",
        "authorized_official_last_name": "RANDLE",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-448-6939",
        "authorized_official_credential": "LICSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.