NPIMap

Organization Active NPI

Brook Lane Behavioral Services, Inc.

Doing business as North Village

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
National Provider Identifier
1417928151
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
12391 Issued in MD
Legal business name
BROOK LANE BEHAVIORAL SERVICES, INC.
Doing business as
North Village
Practice address
18714 N Village
Shopping Center
Hagerstown, MD 21742-2454
Phone
(301) 733-0330
Fax
(301) 733-4038
NPI assigned
Jan 31, 2006
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 12391 MD Primary

Addresses

Primary practice location

18714 N Village
Shopping Center
Hagerstown, MD 21742-2454

Mailing address

13121 Brooklane Dr
Hagerstown, MD 21742-1514
Phone (301) 733-0331

Other identifiers 1

IdentifierTypeStateIssuer
698800800MedicaidMD

Other names 1

  • North Village Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000256 MD Part B Supplier - Clinic/Group Practice 9436140068 Receives reassigned benefits from 25 practitioners
7 other NPIs on this enrollment
Practice locations: Hagerstown, MD; Frederick, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Brook Lane BH Services10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1417928151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 BROOKLANE DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421514",
            "telephone_number": "301-733-0331",
            "fax_number": "301-733-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18714 N VILLAGE",
            "address_2": "SHOPPING CENTER",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422454",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOK LANE BEHAVIORAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "12391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "698800800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.