Organization Active NPI

Optimum Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1639937709
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OPTIMUM MENTAL HEALTH, LLC
Practice address
2300 Garrison Blvd Ste 104
Baltimore, MD 21216-2308
Phone
(667) 771-2776
Fax
(410) 655-3484
NPI assigned
Mar 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Dr. Samson A Omotosho, CRNP-PMHNPI 1295005973
Title
Director & Psychiatric Nurse Practi
Phone
(443) 858-3189

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2300 Garrison Blvd Ste 104
Baltimore, MD 21216-2308

Mailing address

10701 Chapeldale Road
Randallstown, MD 21133
Phone (443) 858-3189

Other names 1

  • Optimum Mental Health Doing business as

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1639937709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 CHAPELDALE ROAD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "21133",
            "telephone_number": "443-858-3189",
            "fax_number": "410-655-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "667-771-2776",
            "fax_number": "410-655-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "OMOTOSHO",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR & PSYCHIATRIC NURSE PRACTI",
        "authorized_official_telephone_number": "443-858-3189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CRNP-PMH"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Mental Health",
            "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 Oct 20, 2025; 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.