Organization Active NPI

KG Mental Help

  • Professional Counselor
  • Elkridge, MD
National Provider Identifier
1487403929
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
KG MENTAL HELP
Practice address
7604 Hearthside Way Unit 1039
Elkridge, MD 21075-7365
Phone
(301) 806-0138
NPI assigned
May 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Miss Keyana Graham, LCPC
Title
Owner
Phone
(301) 806-0138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

7604 Hearthside Way Unit 1039
Elkridge, MD 21075-7365

Mailing address

2115 Dave Thomas LN
Charlotte, NC 28214-2367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250115000240 MD Part B Supplier - Clinic/Group Practice 7214465517 Receives reassigned benefits from 1 practitioner
Practice locations: Elkridge, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1487403929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 DAVE THOMAS LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 HEARTHSIDE WAY UNIT 1039",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757365",
            "telephone_number": "301-806-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KG MENTAL HELP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KEYANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-806-0138",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.