NPIMap

Organization Active NPI

Primal Point LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
National Provider Identifier
1114691672
Registry record updated Sep 11, 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
PRIMAL POINT LLC
Practice address
9001 Harford Rd
Parkville, MD 21234-4029
Phone
(410) 870-1590
NPI assigned
Aug 6, 2021
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Ngufor Fube DivineNPI 1669197208
Title
President
Phone
(240) 423-8757

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

9001 Harford Rd
Parkville, MD 21234-4029

Mailing address

8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone (410) 870-1590

Other practice location 1

8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone (410) 870-1590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210915000015 MD Part B Supplier - Clinic/Group Practice 8820494958 Receives reassigned benefits from 4 practitioners
Practice locations: Parkville, MD

National Provider Directory

National Provider Directory
Tax ID family
Primal Point LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114691672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "410-870-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344029",
            "telephone_number": "410-870-1590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8713 Harford Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212344650",
            "country_code": "US",
            "telephone_number": "410-870-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMAL POINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FUBE DIVINE",
        "authorized_official_first_name": "NGUFOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-423-8757"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.