NPIMap

Organization Active NPI

Solace Behavioral Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1487472759
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOLACE BEHAVIORAL HEALTH SERVICES
Practice address
6 Post Office Rd Ste 103
Waldorf, MD 20602-2746
Phone
(301) 213-1282
NPI assigned
Sep 26, 2024
Last updated
Oct 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Tolulope Oguntomi, MSN, CRNPNPI 1881221265
Title
Owner
Phone
(301) 213-1282

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

6 Post Office Rd Ste 103
Waldorf, MD 20602-2746

Mailing address

12308 Markby CT
Upper Marlboro, MD 20774-5647
Phone (301) 213-1282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241014001176 MD Part B Supplier - Clinic/Group Practice 5799217915 Receives reassigned benefits from 4 practitioners
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Locations

6 Post Office Rd
Ste 103
Waldorf, MD 20602
Phone (301) 213-1282

Practitioners & affiliated clinicians

Practitioners 4

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": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1487472759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12308 MARKBY CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745647",
            "telephone_number": "301-213-1282",
            "fax_number": "240-624-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 POST OFFICE RD STE 103",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022746",
            "telephone_number": "301-213-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "OGUNTOMI",
        "authorized_official_first_name": "TOLULOPE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-213-1282",
        "authorized_official_credential": "MSN, CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.