NPIMap

Organization Active NPI

Adult Behavioral Health Program

  • Health Maintenance Organization
  • Wheaton, MD
National Provider Identifier
1477639631
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
265391500 Issued in MD
Legal business name
ADULT BEHAVIORAL HEALTH PROGRAM
Practice address
2424 Reedie Dr FL 3
Wheaton, MD 20902-4624
Phone
(240) 777-1323
Fax
(240) 777-3226
NPI assigned
Oct 31, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Miss Randall Mary Ingate, LCSW-C
Title
Clinical Supervisor
Phone
(240) 777-1384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 265391500 MD Primary

Addresses

Primary practice location

2424 Reedie Dr FL 3
Wheaton, MD 20902-4624

Mailing address

2424 Reedie Dr FL 3
Wheaton, MD 20902-4624
Phone (240) 777-1323

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherMDNONE

National Provider Directory

National Provider Directory
Tax ID family
Dept of Addiction MNT99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2424 Reedie Dr
Fl 3
Wheaton, MD 20902
Phone (240) 777-1323

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1477639631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 REEDIE DR FL 3",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209024624",
            "telephone_number": "240-777-1323",
            "fax_number": "240-777-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 REEDIE DR FL 3",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209024624",
            "telephone_number": "240-777-1323",
            "fax_number": "240-777-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT BEHAVIORAL HEALTH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "INGATE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "240-777-1384",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MD",
            "license": "265391500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.