NPIMap

Organization Active NPI

Moral Peak Mental Health & Wellness, LLC.

  • Primary Care Clinic/Center
  • Severn, MD
National Provider Identifier
1518625219
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MORAL PEAK MENTAL HEALTH & WELLNESS, LLC.
Practice address
1417 Winter Pine TRL
Severn, MD 21144-1506
Phone
(301) 675-6471
NPI assigned
Nov 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Kassandra DickensNPI 1871890301
Title
Provider
Phone
(301) 675-6471

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1417 Winter Pine TRL
Severn, MD 21144-1506

Mailing address

1417 Winter Pine TRL
Severn, MD 21144-1506
Phone (301) 675-6471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220331002512 MD Part B Supplier - Clinic/Group Practice 4688060569 Receives reassigned benefits from 2 practitioners
Practice locations: Severn, MD

National Provider Directory

National Provider Directory
Tax ID family
Moral Peak Mental Health Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1518625219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 WINTER PINE TRL",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441506",
            "telephone_number": "301-675-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 WINTER PINE TRL",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441506",
            "telephone_number": "301-675-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORAL PEAK MENTAL HEALTH & WELLNESS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "DICKENS",
        "authorized_official_first_name": "KASSANDRA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "301-675-6471"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severn, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.