NPIMap

Organization Active NPI

My Covenant Place Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Largo, MD
National Provider Identifier
1558010603
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MY COVENANT PLACE BEHAVIORAL HEALTH
Practice address
9701 Apollo Dr Ste 411
Largo, MD 20774-4783
Phone
(443) 759-3355
Fax
(301) 476-0076
NPI assigned
Mar 23, 2022
Organization subpart
Yes
Parent organization
MY COVENANT PLACEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Latisha Carter
Title
Ceo
Phone
(301) 577-7307

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

9701 Apollo Dr Ste 411
Largo, MD 20774-4783

Mailing address

10630 Little Patuxent Pkwy Ste 113
Columbia, MD 21044-6225
Phone (410) 200-9192

Other practice location 1

9750 Apollo Drive
Suite B
Largo, MD 20774
Phone (301) 577-7307

Other practice location 2

9701 Arena Drive
Suite 411
Largo, MD 20774-2077
Phone (301) 577-7307

Other practice location 3

10630 Little Patuxent Pkwy Ste 314D
Columbia, MD 21044-6216
Phone (410) 200-9292

Other practice location 4

5109 York Rd Ste C
Baltimore, MD 21212-4399
Phone (443) 759-3355

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lcarter@mycovenantplace.org Direct

National Provider Directory

National Provider Directory
Tax ID family
My Covenant Place Behavioral Health7 organizations share this tax ID, including this one
Part of
My Covenant Place Behavioral Health

Other organizations with this tax ID 6

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

Locations

5109 York Rd
Ste C
Baltimore, MD 21212
Phone (443) 759-3355

9750 Apollo Dr
Ste B
Largo, MD 20774
Phone (301) 577-7307

9701 Apollo Dr
Ste 411
Upper Marlboro, MD 20774
Phone (301) 577-7307

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1558010603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PKWY STE 113",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446225",
            "telephone_number": "410-200-9192",
            "fax_number": "301-476-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 411",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744783",
            "telephone_number": "443-759-3355",
            "fax_number": "301-476-0076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9750 APOLLO DRIVE",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "MD",
            "postal_code": "20774",
            "country_code": "US",
            "telephone_number": "301-577-7307",
            "fax_number": "301-476-0076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9701 Arena Drive",
            "address_2": "Suite 411",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "MD",
            "postal_code": "207742077",
            "country_code": "US",
            "telephone_number": "301-577-7307",
            "fax_number": "301-476-0076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10630 Little Patuxent Pkwy Ste 314D",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210446216",
            "country_code": "US",
            "telephone_number": "410-200-9292",
            "fax_number": "301-476-0076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5109 York Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212124399",
            "country_code": "US",
            "telephone_number": "443-759-3355",
            "fax_number": "443-990-0009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY COVENANT PLACE BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY COVENANT PLACE",
        "enumeration_date": "2022-03-23",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-577-7307"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcarter@mycovenantplace.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9750 APOLLO DRIVE",
            "address_2": "Suite B",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.