Upstream Journeys LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

UPSTREAM JOURNEYS LLC

Practice address

4690 Millennium Dr Ste 300
Belcamp, MD 21017-1527

Phone

(410) 888-7740

NPI assigned

Aug 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jendayi Gantt, DNP, CNM, PMHNP-BCNPI 1235386939

Title

Practice Owner

Phone

(410) 888-7740

Specialties & licenses 1

Addresses

Other identifiers 1

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

• Jendayi Gantt, DNP, CNM, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Belcamp, MD
  • NPI 1235386939
  NPD Authorized official

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1295565190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 MILLENNIUM DR STE 300",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171527",
            "telephone_number": "410-888-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 MILLENNIUM DR STE 300",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171527",
            "telephone_number": "410-888-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTREAM JOURNEYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "JENDAYI",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "410-888-7740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CNM, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHIATRIC NURSE PRACTITIONER",
            "identifier": "1235386939",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunrise Health Care Agency LLC
• Anita Sutton
• Synergy Medical Group LLC
• Tele911 Maryland Emergency Medical Group PA
• Twenty Four Hour Dependable Medical Supplies, LLC
• Jessica Van Brunt Hobgood, LCSW-C
• Gia Vecchioni
• Vinita Patanaphan MD PA
• Walgreen Co
• Walgreen Co.

• All providers in Belcamp, MD
• Adult Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.