NPIMap

Organization Active NPI

Ellicott City Mental Health LLC

  • Psychiatry Physician
  • Columbia, MD
National Provider Identifier
1316404411
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ELLICOTT CITY MENTAL HEALTH LLC
Practice address
9256 Bendix Rd Ste 200B
Columbia, MD 21045-1848
Phone
(443) 542-0773
NPI assigned
Feb 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Anandraj MattaiNPI 1407070881
Title
Owner
Phone
(443) 542-0773

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

9256 Bendix Rd Ste 200B
Columbia, MD 21045-1848

Mailing address

9256 Bendix Rd Ste 200B
Columbia, MD 21045-1848
Phone (443) 542-0773

National Provider Directory

National Provider Directory

Locations

9256 Bendix Rd
Ste 200B
Columbia, MD 21045
Phone (443) 542-0773

Practitioners & affiliated clinicians

Practitioners 6

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": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1316404411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9256 BENDIX RD STE 200B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451848",
            "telephone_number": "443-542-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9256 BENDIX RD STE 200B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451848",
            "telephone_number": "443-542-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLICOTT CITY MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MATTAI",
        "authorized_official_first_name": "ANANDRAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-542-0773"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.