NPIMap

Organization Active NPI

M&M Behavioral Health Solutions

  • Professional Counselor
  • Glen Burnie, MD
National Provider Identifier
1134525710
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC3585 Issued in MD
Legal business name
M&M BEHAVIORAL HEALTH SOLUTIONS
Practice address
1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086
Phone
(410) 766-6624
Fax
(410) 766-0240
NPI assigned
Nov 10, 2014
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Mrs. Ann McCoy, LCPC
Title
Clinical Director
Phone
(410) 766-6624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC3585 MD Primary

Addresses

Primary practice location

1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086

Mailing address

1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086
Phone (410) 766-6624

Other identifiers 1

IdentifierTypeStateIssuer
455107900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160727000859 MD Part B Supplier - Clinic/Group Practice 1355634437 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
Practice locations: Glen Burnie, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
MM Behavioral HLTH Sol4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1134525710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HWY S STE 104",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614086",
            "telephone_number": "410-766-6624",
            "fax_number": "410-766-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HWY S STE 104",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614086",
            "telephone_number": "410-766-6624",
            "fax_number": "410-766-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&M BEHAVIORAL HEALTH SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-766-6624",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455107900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.