Organization Active NPI

Overcomer Mental Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brunswick, MD
National Provider Identifier
1124995287
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OVERCOMER MENTAL HEALTH SERVICES LLC
Practice address
1130 Dargon Quarry LN # 1130
Brunswick, MD 21716-9731
Phone
(410) 892-1835
NPI assigned
Oct 22, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Adesola AdefowojuNPI 1518713668
Title
Owner Authorized Official
Phone
(410) 892-1835

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
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1130 Dargon Quarry LN # 1130
Brunswick, MD 21716-9731

Mailing address

1130 Dargon Quarry LN # 1130
Brunswick, MD 21716-9731
Phone (410) 892-1835

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201002493 MD Part B Supplier - Clinic/Group Practice 3678066479 Receives reassigned benefits from 1 practitioner
Practice locations: Brunswick, MD

National Provider Directory

National Provider Directory

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": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1124995287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 DARGON QUARRY LN # 1130",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217169731",
            "telephone_number": "410-892-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 DARGON QUARRY LN # 1130",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217169731",
            "telephone_number": "410-892-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERCOMER MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "ADEFOWOJU",
        "authorized_official_first_name": "ADESOLA",
        "authorized_official_title_or_position": "OWNER AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "410-892-1835"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.