Organization Active NPI

Brightlite Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pikesville, MD
National Provider Identifier
1588404529
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BRIGHTLITE BEHAVIORAL HEALTH LLC
Practice address
1829 Reisterstown Rd # 325
Pikesville, MD 21208-6320
Phone
(443) 901-3777
Fax
(443) 901-3787
NPI assigned
May 28, 2024
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Janet Adetola, MSN, CRNPNPI 1700585809
Title
Owner of Entity
Phone
(410) 672-7028

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 Practitioner 363LP0808X Primary

Addresses

Primary practice location

1829 Reisterstown Rd # 325
Pikesville, MD 21208-6320

Mailing address

1829 Reisterstown Rd # 325
Pikesville, MD 21208-6320
Phone (443) 901-3777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240607001166 MD Part B Supplier - Clinic/Group Practice 5193267953 Receives reassigned benefits from 1 practitioner
Practice locations: Pikesville, MD

National Provider Directory

National Provider Directory

Locations

1829 Reisterstown Rd
#325
Pikesville, MD 21208
Phone (410) 672-7028

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": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1588404529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD # 325",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086320",
            "telephone_number": "443-901-3777",
            "fax_number": "443-901-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD # 325",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086320",
            "telephone_number": "443-901-3777",
            "fax_number": "443-901-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLITE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "ADETOLA",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "410-672-7028",
        "authorized_official_credential": "MSN, CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.