NPIMap

Organization Active NPI

MMBR Behavioral Health Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Brooklyn, MD
National Provider Identifier
1457938359
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
MMBR BEHAVIORAL HEALTH SERVICES INC
Practice address
3804 S.Hanover Street
Brooklyn, MD 20774
Phone
(443) 438-3457
NPI assigned
Mar 26, 2021
Last updated
Mar 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Mrs. Bolakunmi Yusuf
Title
Manager
Phone
(443) 438-3457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

3804 S.Hanover Street
Brooklyn, MD 20774

Mailing address

3804 S.Hanover Street
Brooklyn, MD 20774
Phone (443) 438-3457

Other identifiers 1

IdentifierTypeStateIssuer
3016555086MedicaidMD

Other names 1

  • MMBR INC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mmbr.bhs@gmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
MMBR Behavioral Health Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1457938359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 S.HANOVER STREET",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "443-438-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 S.HANOVER STREET",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "443-438-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMBR BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "YUSUF",
        "authorized_official_first_name": "BOLAKUNMI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "443-438-3457",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016555086",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mmbr.bhs@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3804 S.HANOVER STREET",
            "city": "BROOKLYN",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MMBR INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brooklyn, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.