Fairland Behavioral Health Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAIRLAND BEHAVIORAL HEALTH INC

Practice address

6110 Main St
Lanham, MD 20706-2749

Phone

(301) 793-9605

NPI assigned

Mar 14, 2021

Organization subpart

No

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

Authorized official

Name

Chidiadi B Agoh, PMHNP, FNPNPI 1710370945

Title

President

Phone

(301) 793-9605

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 2

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

• Chidiadi Agoh

  • Psychiatric/Mental Health Nurse Practitioner
  • Lutherville, MD
  • NPI 1710370945

  DC

  Medicare reassignment NPD Authorized official
• Chinyere Recheal Nzekwe, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1487235172

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615680000000",
    "number": "1316522006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 MAIN ST",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062749",
            "telephone_number": "301-793-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MAIN ST",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062749",
            "telephone_number": "301-793-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRLAND BEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A",
        "authorized_official_last_name": "AGOH",
        "authorized_official_first_name": "CHIDIADI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-793-9605",
        "authorized_official_credential": "PMHNP, FNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fade to Black Anesthesia Services
• Olushile Fadoju
• Adeola Fagbohunka, PA
• Emmanuel K. Fai, PA-C, PHD
• Joyce Fai
• Taiwo Fakeye
• Thelma Falana, PHARMD
• Falcon Home Healthcare Agency
• Abu B Fallah
• Family Advocacy Network

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lanham, MD
• Providers in Lanham, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2021; 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.