Individual provider Active NPI

Kevin Eugene Harvell

  • Adolescent and Children Mental Health Clinic/Center
  • Baltimore, MD
National Provider Identifier
1205440195
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Practice address
3435 Greenmount Ave Ste 1
Baltimore, MD 21218-2942
Phone
(443) 708-0360
Fax
(667) 303-3152
NPI assigned
Sep 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X MD Primary

Addresses

Primary practice location

3435 Greenmount Ave Ste 1
Baltimore, MD 21218-2942

Mailing address

3435 Greenmount Ave Ste 1
Baltimore, MD 21218-2942
Phone (443) 708-0360

Other identifiers 1

IdentifierTypeStateIssuer
000000000MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL khbehavioralhealth@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Health Care Services Company, LLC Current Accepting new patients
KH Behavioral Health Center PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1205440195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 GREENMOUNT AVE STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182942",
            "telephone_number": "443-708-0360",
            "fax_number": "667-303-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 GREENMOUNT AVE STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182942",
            "telephone_number": "443-708-0360",
            "fax_number": "667-303-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVELL",
        "first_name": "KEVIN",
        "middle_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "khbehavioralhealth@gmail.com",
            "affiliation": "N",
            "endpointDescription": "khbehavioralhealth@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "3435 Greenmount Ave Ste 1",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212182942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.