NPIMap

Organization Active NPI

My Covenant Place Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Largo, MD
National Provider Identifier
1679222715
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MY COVENANT PLACE BEHAVIORAL HEALTH
Practice address
9701 Apollo Dr Ste 411
Largo, MD 20774-4783
Phone
(301) 577-7307
Fax
(301) 476-0076
NPI assigned
Mar 23, 2022
Organization subpart
Yes
Parent organization
MY COVENANT PLACE BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 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) 200-9290

Other practice location 1

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

Other practice location 2

5109 York Rd
Baltimore, MD 21212-4399
Phone (443) 759-3355 ext. 107

Other practice location 3

10630 Little Patuxent Pkwy Ste 314D
Columbia, MD 21044-6216
Phone (410) 200-9290

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.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

10630 Little Patuxent Pkwy
Ste 314D
Columbia, MD 21044
Phone (410) 200-9290

9750 Apollo Dr
Ste B
Largo, 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": "1673222400000",
    "number": "1679222715",
    "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": "410-200-9290",
            "fax_number": "301-476-0078"
        },
        {
            "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": "301-577-7307",
            "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": "5109 York Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212124399",
            "country_code": "US",
            "telephone_number": "443-759-3355 x107",
            "fax_number": "443-990-0009",
            "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": "410-200-9290",
            "fax_number": "301-476-0076",
            "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 BEHAVIORAL HEALTH",
        "enumeration_date": "2022-03-23",
        "last_updated": "2023-01-09",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mycovenantplace.org",
            "affiliation": "N",
            "endpointDescription": "Behavioral Health Programming",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "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 9, 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.