Momentum Behavioral Health Consultants and Parent Coaching

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MOMENTUM BEHAVIORAL HEALTH CONSULTANTS AND PARENT COACHING

Practice address

6607 Fannon Dr
Bowie, MD 20720-4729

Phone

(504) 284-8837

NPI assigned

May 24, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Colleen Michelle Wallace, MD

Title

President

Phone

(504) 284-8837

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1467190900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 FANNON DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204729",
            "telephone_number": "504-284-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 FANNON DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204729",
            "telephone_number": "504-284-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM BEHAVIORAL HEALTH CONSULTANTS AND PARENT COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-284-8837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noella Ngweminang Mofor
• Wiaam Mohamed
• Alex S Mohseni, MD
• Tawana Moise
• Ashley Margaret Mollman, BCBA, LBA
• Maryrose Ijeoma Moneke
• Mallaury Ketsia Monny Moukoko
• Denise Montgomery, LICSW, LCSW-C, LMFT
• Francesca Alexis Montgomery, LCPC
• Tyrus Gerard Montgomery, DMD

• Pediatrics Physician in Bowie, MD
• Providers in Bowie, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.