Organization Active NPI

Mental Health First, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1164018842
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MENTAL HEALTH FIRST, LLC
Practice address
5457 Twin Knolls Road
Suite 300 #1048
Columbia, MD 21045-3414
Phone
(410) 424-7262
Fax
(855) 743-0059
NPI assigned
Dec 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Mrs. Jacqueline Williams, NPNPI 1588270458
Title
Psychiatric Nurse Practitioner
Phone
(443) 900-7181

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5457 Twin Knolls Road
Suite 300 #1048
Columbia, MD 21045-3414

Mailing address

5457 Twin Knolls Rd
Ste 300 #1048
Columbia, MD 21045-3296
Phone (410) 424-7262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231120000285 MD Part B Supplier - Clinic/Group Practice 7315395050 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

5457 Twin Knolls Rd
#1048
Columbia, MD 21045
Phone (410) 424-7262

5457 Twin Knolls Rd
Ste 1048
Columbia, MD 21045

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1164018842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD",
            "address_2": "STE 300 #1048",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453296",
            "telephone_number": "410-424-7262",
            "fax_number": "855-743-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS ROAD",
            "address_2": "SUITE 300 #1048",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453414",
            "telephone_number": "410-424-7262",
            "fax_number": "855-743-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH FIRST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "443-900-7181",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.