Fello Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Severn, MD
NPI 1215515341 · NPPES record last updated Sep 30, 2025
Key facts
- NPI
- 1215515341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- FELLO INC
- Practice address
- 1332 Donald Ave
Severn, MD 21144-2630 - Phone
- (410) 269-1883
- Fax
- (410) 384-4015
- NPI assigned
- Mar 30, 2021
- Organization subpart
- No
Authorized official
- Name
- Jose Ochoa
- Title
- Cfo
- Phone
- (410) 269-1883
Other NPIs on the same Medicare enrollment 3
Subparts reporting this organization as parent 3
Corporate family (same tax ID) 3
Practitioners 6
-
Dawn K Davis-Brodeur, M.A., LCPC
-
Gina Mobley, LCPC
-
Carrie Lee O'Connor, LGSW
-
Elisabeth Turner, LCSWC
-
Madeline Cochran, LCSW-C
-
Amani Zuri-Chanel Nyansa, LCSW-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210720000113 | MD | Part B Supplier - Clinic/Group Practice | 4880097534 |
Receives reassigned benefits from 6 practitioners 3 other NPIs on this enrollment Practice locations: Annapolis, MD; Easton, MD; Linthicum Heights, MD; Severn, MD |
National Provider Directory
- Tax ID family
- Fello Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
1332 Donald Ave
Severn, MD 21144-2630
Mailing address
999 Corporate Blvd Ste 300
Linthicum, MD 21090-2271
Phone (410) 269-1883
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156442100 | Medicaid | MD | |
| 889034000 | Medicaid | MD |
Other providers in Severn, MD
- Violet Fadimatou
- Aimee Fadio Koumetio Epse Simo
- Gregory Oluremi Fakorede
- Oluwatoyin Esther Falana
- Bosede Fatusin
- Mari Fernandez
- Edwin Z Freeman
- Marisa S Garcia Faust
- William J Gaurin
- Rachel Marie Gianforte
All providers in Severn, MD · Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.