Camphire Initiative LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

CAMPHIRE INITIATIVE LLC

Practice address

14440 Cherry Lane CT Ste 102
Laurel, MD 20707-4946

Phone

(202) 763-2409

NPI assigned

Apr 5, 2025

Organization subpart

No

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

Authorized official

Name

Yetunde OdoleNPI 1891543195

Title

Pmhnp

Phone

(202) 763-2409

Specialties & licenses 2

Addresses

Other names 1

• BalanceCare Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yetunde Odole, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1891543195

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743811200000",
    "number": "1144014226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 RAILBED DR",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211133733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT STE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074946",
            "telephone_number": "202-763-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPHIRE INITIATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A",
        "authorized_official_last_name": "ODOLE",
        "authorized_official_first_name": "YETUNDE",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "202-763-2409"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BalanceCare Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Laurel, MD
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.