NPIMap

Organization Active NPI

The Elysian Fields Optimum Wellness and Mental Health Group, LLC

Doing business as T

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1568824472
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLC
Doing business as
T
The Seventy Times Seven Wellness Mission
Practice address
2222 N Howard St
Baltimore, MD 21218-5609
Phone
(410) 624-5037
NPI assigned
Mar 22, 2016
Last updated
Mar 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Mr. Arthur R Griffin Jr., MISE, MBA
Title
Principal
Phone
(913) 226-9499

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Pastoral Counselor 101YP1600X NU
Adult Development & Aging Psychologist 103TA0700X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Counseling Psychologist 103TC1900X NU
Exercise & Sports Psychologist 103TE1100X NU
Health Service Psychologist 103TH0100X NU
Psychoanalysis Psychologist 103TP0814X NU
Group Psychotherapy Psychologist 103TP2701X NU
Rehabilitation Psychologist 103TR0400X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Community/Behavioral Health Agency 251S00000X NU Primary
Psychoanalyst 102L00000X NU
Prescribing (Medical) Psychologist 103TP0016X NU

Addresses

Primary practice location

2222 N Howard St
Baltimore, MD 21218-5609

Mailing address

2222 N Howard St
Baltimore, MD 21218-5609
Phone (410) 624-5037

Other practice location 1

2107 N Charles St
1st Floor - Right Side
Baltimore, MD 21218-5717
Phone (410) 624-5037

Other names 2

  • T Doing business as
  • The Seventy Times Seven Wellness Mission Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230726002222 MD Part B Supplier - Clinic/Group Practice 8426419235 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
Practice locations: Baltimore, MD

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Elysian Fields Optimum Wellness and Mental Health Group LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the 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, 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": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1568824472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N HOWARD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185609",
            "telephone_number": "410-624-5037",
            "fax_number": "800-405-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N HOWARD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185609",
            "telephone_number": "410-624-5037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2107 N Charles St",
            "address_2": "1st Floor - Right Side",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212185717",
            "country_code": "US",
            "telephone_number": "410-624-5037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "913-226-9499",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MISE, MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Seventy Times Seven Wellness Mission",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Seventy Times Seven Wellness Mission",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

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