Archibald Optimal Health Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11283 Issued in MD

Legal business name

ARCHIBALD OPTIMAL HEALTH SERVICES, LLC

Practice address

1431 E Baltimore St
Baltimore, MD 21231-1405

Phone

(410) 258-1872

Fax

(410) 342-4130

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Paul Archibald

Title

Program Director

Phone

(410) 357-1404

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1518315944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919A YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 E BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311405",
            "telephone_number": "410-258-1872",
            "fax_number": "410-342-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5919A York Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212123027",
            "country_code": "US",
            "telephone_number": "410-357-1404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARCHIBALD OPTIMAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-357-1404"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2783",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2342",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "73960",
            "identifier": "732960",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Fedyk Archer
• Archers Lovely Hearts Home Care &Nrsa
• Archers Lovely Hearts Home Care &Nrsa
• Archers Lovely Hearts Home Care &Nrsa
• Archibald Optimal Health Services, LLC
• Paul Clifford Archibald, MA, LCSW-C
• Jamie Archibong, M.A.
• Eyamba Archibong, LCSW-C
• Samantha Ann Archibong, CRNP-PMH
• Vivian Archibong, LCSW-C

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.