1 Axium, LLC

Organization Active NPI Community/Behavioral Health Agency · Beltsville, MD

NPI 1346697208 · NPPES record last updated Nov 5, 2024

Key facts

NPI
1346697208
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
1 AXIUM, LLC
Practice address
4041 Powder Mill Rd Ste 300
Beltsville, MD 20705-3106
Phone
(202) 808-2878
Fax
(202) 506-2754
NPI assigned
May 20, 2016
Organization subpart
No

Authorized official

Name
Dr. Gwendolyn Love Kimbrough, PHD
Title
Ceo
Phone
(202) 808-2878

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
1 Axium LLC (2 organizations share this tax ID)

Locations

3420 9th St NE
Washington, DC 20017

3000 Connecticut Ave NW
Apt 321
Washington, DC 20008
Phone (202) 265-2343

10410 Kensington Pkwy
Ste 101
Kensington, MD 20895

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X
Behavior Analyst
Group: 193200000X MULTI-SPECIALTY GROUP
103K00000X
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC0700X
Group Psychotherapy Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TP2701X
Rehabilitation Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TR0400X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X
Marriage & Family Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
106H00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X Yes
In Home Supportive Care Agency 253Z00000X
Respite Care 385H00000X

Addresses

Primary practice location

4041 Powder Mill Rd Ste 300
Beltsville, MD 20705-3106

Mailing address

4041 Powder Mill Rd Ste 300
Beltsville, MD 20705-0004
Phone (202) 808-2878

Other identifiers

IdentifierTypeStateIssuer
018287987MedicaidDC

Other names

  • 1st Axium, LLC Other name

Other providers in Beltsville, MD

All providers in Beltsville, MD · Community/Behavioral Health Agency in Maryland

Sources for this page

Verify at the official NPI Registry.