Life Quality Psychiatric Multi Disciplinary Group, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LIFE QUALITY PSYCHIATRIC MULTI DISCIPLINARY GROUP, LLC

Practice address

604 S Frederick Ave
Suite 211
Gaithersburg, MD 20877-1275

Phone

(301) 330-6470

Fax

(301) 330-6472

NPI assigned

Feb 1, 2012

Last updated

Feb 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Mona Attia

Title

Owner -Manager

Phone

(301) 330-6470

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1154693588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE",
            "address_2": "SUITE 211",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771275",
            "telephone_number": "301-330-6470",
            "fax_number": "301-330-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE",
            "address_2": "SUITE 211",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771275",
            "telephone_number": "301-330-6470",
            "fax_number": "301-330-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE QUALITY PSYCHIATRIC MULTI DISCIPLINARY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "ATTIA",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER -MANAGER",
        "authorized_official_telephone_number": "301-330-6470",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.