My Covenant Place

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MY COVENANT PLACE

Practice address

9701 Apollo Dr Ste 4114TH
Largo, MD 20774-4783

Phone

(301) 577-7307

Fax

(301) 476-0076

NPI assigned

Dec 9, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Latisha Carter

Title

Ceo/Executive Director

Phone

(301) 577-7307

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• My Covenant Place Behavioral Health

  • Community/Behavioral Health Agency
  • Largo, MD
  • NPI 1326704073
  NPPES parent name
• My Covenant Place Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Largo, MD
  • NPI 1558010603
  NPPES parent name

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1164853669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PKWY STE 113",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446225",
            "telephone_number": "410-200-9290",
            "fax_number": "301-476-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 4114TH",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744783",
            "telephone_number": "301-577-7307",
            "fax_number": "301-476-0076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5109 York Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212124399",
            "country_code": "US",
            "telephone_number": "443-759-3355",
            "fax_number": "443-990-0009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10630 Little Patuxent Pkwy Ste 314D",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210446216",
            "country_code": "US",
            "telephone_number": "410-200-9290",
            "fax_number": "301-476-0076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Medical Center Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "MD",
            "postal_code": "207743703",
            "country_code": "US",
            "telephone_number": "301-577-7307",
            "fax_number": "301-476-0076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY COVENANT PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-577-7307",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19125M99",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mycovenantplace.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9500 Medical Center Dr Ste 104",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207743703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mt. Washington Pediatric Hospital Inc. (Mt. Washington Physicians Group)
• Zainab Mujahid
• Mrinalini Meagan Mukhia, PHARMD
• Larita Patrice Mullins, LCSW-C, LICSW
• Biah Mustafa
• My Covenant Place Behavioral Health
• My Covenant Place Behavioral Health
• My Covenant Place Behavioral Health
• My Write Mind, LLC
• N3O Homecare, LLC (N3O Enterprises, LLC)

• Community/Behavioral Health Agency in Largo, MD
• Providers in Largo, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.