Target Behavioral Health Services, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

TARGET BEHAVIORAL HEALTH SERVICES, LLC

Practice address

15 E Churchville Rd Ste 106
Bel Air, MD 21014-3837

Phone

(410) 888-7143

Fax

(410) 888-7145

NPI assigned

Aug 7, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Folashade Kanimodo, CRNPNPI 1417174889

Title

Ceo

Phone

(410) 900-8897

Specialties & licenses 2

Addresses

Other names 1

• Target Behavioral Health Services, LLC Other name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Target Behavioral Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bel Air, MD
  • NPI 1245811009

  O20220120000204

  Same enrollment

Tax ID family

Target Behavioral Health Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Target Behavioral Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bel Air, MD
  • NPI 1245811009
  NPD tax ID

Locations

Practitioners 1

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

• Folashade R Kanimodo, FNP-BC, PMHNP-BC

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1417174889

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1235749771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 MOONSHADOW RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210154999",
            "telephone_number": "410-900-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E CHURCHVILLE RD STE 106",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143837",
            "telephone_number": "410-888-7143",
            "fax_number": "410-888-7145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Moonshadow Rd",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210154999",
            "country_code": "US",
            "telephone_number": "410-900-8897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TARGET BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "KANIMODO",
        "authorized_official_first_name": "FOLASHADE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-900-8897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Target Behavioral Health Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lee Eric Tannenbaum, M.D.
• Stephanie Tantoh
• Bo Tao, DO
• Emily Tarantola, LCPC
• Briar Tarbert
• Target Behavioral Health Services, LLC
• Elisabeth Ann Tauber
• Tore Taxdal, LCSW-C
• Alison Lauren Taylor, LCSW-C
• Angelica Taylor, LCSW-C

• Psychiatric/Mental Health Nurse Practitioner in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.