First Health Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FIRST HEALTH SERVICES LLC

Practice address

4411 Southern Ave
Capitol Heights, MD 20743-5639

Phone

(249) 615-6881

NPI assigned

May 3, 2021

Last updated

May 3, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

FIRST HEALTH SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Dr. Stanislus Eban

Title

Ceo

Phone

(240) 615-6881

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Tax ID family

First Health Services LLC4 organizations share this tax ID, including this one

Part of

First Health Services LLC

Other organizations with this tax ID 3

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

• First Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Capitol Heights, MD
  • NPI 1043964885
  NPD tax ID
• First Health Services LLC

  • Addiction (Substance Use Disorder) Counselor
  • Capitol Heights, MD
  • NPI 1508650730
  NPD tax ID
• First Health Services LLC

  • Social Worker
  • Capitol Heights, MD
  • NPI 1609717883
  NPD tax ID

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.

• Fulgentia Smith, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Beltsville, MD
  • NPI 1043925035

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1669055091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 OLD MILL RD",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081039",
            "telephone_number": "240-615-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SOUTHERN AVE",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207435639",
            "telephone_number": "249-615-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST HEALTH SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST HEALTH SERVICES LLC",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "EBAN",
        "authorized_official_first_name": "STANISLUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-615-6881",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Millersville",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4411 Southern Ave",
            "city": "Capitol Heights",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207435639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nikisha Lashawn Fauntleroy
• Princess Siah Fayiah
• First Health Services LLC
• First Health Services LLC
• First Health Services LLC
• First-Class Caregivers, LLC
• Craig Jamal Fisher, CNA
• Charles Fongoh
• Dora Alicia Fonseca
• Nelly Fonseca

• Mental Health Counselor in Capitol Heights, MD
• Providers in Capitol Heights, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.