Christina Benboudiaf

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P00111 Issued in NY

Practice address

1434 Harford Square Dr
Edgewood, MD 21040-2212

Phone

(716) 261-9488

NPI assigned

Apr 15, 2015

Last updated

Jan 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maryland Wellness LLCGroup PAC ID 6406278803, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christina.benboudiaf.p1@direct.mdwellness.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1588379739
  Medicare reassignment Care Compare group NPD
• Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1003479668
  NPD

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1124414263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012398",
            "telephone_number": "716-847-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 HARFORD SQUARE DR",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210402212",
            "telephone_number": "716-261-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENBOUDIAF",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P00111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avawell, LLC
• Hilda Tifu Azong, NP
• Kionna Barnes
• Jennifer Tracy Bartlebaugh, M.S., CF-SLP
• Behavioral Health Connections
• Kim Bennett-Selby, LCSW-C
• Cecilia Lariba Bibio, NP
• Amanda Louise Boblitz-McFadden, LCPC
• Emily Boyd
• Patrice Merle Boykin

• Mental Health Counselor in Edgewood, MD
• Providers in Edgewood, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.