Organization Active NPI

Positive Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waldorf, MD
National Provider Identifier
1356259691
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
POSITIVE BEHAVIORAL HEALTH SERVICES
Practice address
11805 Pika Dr Ste a
Waldorf, MD 20602-3732
Phone
(734) 322-7744
NPI assigned
Aug 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Andre Serge Libock
Title
Ceo
Phone
(734) 322-7744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

11805 Pika Dr Ste a
Waldorf, MD 20602-3732

Mailing address

11805 Pika Dr Ste a
Waldorf, MD 20602-3732

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1356259691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 PIKA DR STE A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11805 PIKA DR STE A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023732",
            "telephone_number": "734-322-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "LIBOCK",
        "authorized_official_first_name": "ANDRE SERGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-322-7744"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.