Organization Active NPI

Synchrony Behavioral Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1265283899
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SYNCHRONY BEHAVIORAL HEALTH SERVICES LLC
Doing business as
Synchrony Behavioral Health Services LLC
Practice address
2255 Crain Hwy Ste 205
Waldorf, MD 20601-3190
Phone
(667) 382-8624
Fax
(667) 218-3708
NPI assigned
Apr 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Authorized official

Name
Doris OgunmakinwaNPI 1891559746
Title
Owner/Ceo
Phone
(667) 382-8624

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: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2255 Crain Hwy Ste 205
Waldorf, MD 20601-3190

Mailing address

2925 Winterbourne Dr
Upper Marlboro, MD 20774-9103

Other practice location 1

2 Industrial Park Dr Ste D
Waldorf, MD 20602-2729
Phone (667) 382-8624

Other names 1

  • Synchrony Behavioral Health Services LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240503000135 MD Part B Supplier - Clinic/Group Practice 0345680609 Receives reassigned benefits from 1 practitioner
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Locations

2 Industrial Park Dr
Ste D
Waldorf, MD 20602
Phone (667) 382-8624

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": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780185600000",
    "number": "1265283899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 WINTERBOURNE DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CRAIN HWY STE 205",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013190",
            "telephone_number": "667-382-8624",
            "fax_number": "667-218-3708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Industrial Park Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022729",
            "country_code": "US",
            "telephone_number": "667-382-8624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNCHRONY BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A",
        "authorized_official_last_name": "OGUNMAKINWA",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "667-382-8624"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synchrony Behavioral Health Services LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Synchrony Behavioral Health Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; 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.