NPIMap

Organization Active NPI

Fundamental Solutions Psychotherapy. LLC

  • Adult Mental Health Clinic/Center
  • Marriottsville, MD
National Provider Identifier
1447995253
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
FUNDAMENTAL SOLUTIONS PSYCHOTHERAPY. LLC
Practice address
11155 Stratfield CT
Marriottsville, MD 21104-1650
Phone
(410) 487-9477
NPI assigned
May 5, 2022
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Mrs. Candice Mitchell, LGPC NCCNPI 1760066062
Title
Clincial Psychotherapist
Phone
(410) 487-9477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

11155 Stratfield CT
Marriottsville, MD 21104-1650

Mailing address

11155 Stratfield CT
Marriottsville, MD 21104-1650
Phone (410) 487-9477

National Provider Directory

National Provider Directory

Locations

11155 Stratfield Ct
Marriottsville, MD 21104
Phone (410) 487-9477

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1447995253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 STRATFIELD CT",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041650",
            "telephone_number": "410-487-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 STRATFIELD CT",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041650",
            "telephone_number": "410-487-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL SOLUTIONS PSYCHOTHERAPY. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "CLINCIAL PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "410-487-9477",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LGPC NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marriottsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.