Amicable Behavioral Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

AMICABLE BEHAVIORAL HEALTH LLC

Practice address

7310 Governor Ritchie Hwy Ste 200-GB26
Glen Burnie, MD 21061-3065

Phone

(202) 403-9934

NPI assigned

Jun 11, 2024

Last updated

Sep 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amaechi Imelda Olumba, NURSE PRACTITIONERNPI 1689911075

Title

Pmhnp-NP

Phone

(202) 403-9934

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amaechi Imelda Olumba

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
  • NPI 1689911075
  Authorized official Same address or phone

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1396587226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 GUINEVERE RD",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207698939",
            "telephone_number": "202-403-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 GOVERNOR RITCHIE HWY STE 200-GB26",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613065",
            "telephone_number": "202-403-9934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12311 Guinevere Rd",
            "address_purpose": "LOCATION",
            "city": "Glenn Dale",
            "state": "MD",
            "postal_code": "207698939",
            "country_code": "US",
            "telephone_number": "202-403-9934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMICABLE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "OLUMBA",
        "authorized_official_first_name": "AMAECHI",
        "authorized_official_middle_name": "IMELDA",
        "authorized_official_title_or_position": "PMHNP-NP",
        "authorized_official_telephone_number": "202-403-9934",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.