Brilliance Behavioral Health

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

BRILLIANCE BEHAVIORAL HEALTH

Practice address

16701 Melford Blvd Ste 400
Bowie, MD 20715-4411

Phone

(301) 852-8177

NPI assigned

Feb 3, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Raquel Gordon

Title

Psychologist

Phone

(301) 852-8177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1679279327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 MELFORD BLVD STE 400",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 MELFORD BLVD STE 400",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154411",
            "telephone_number": "301-852-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANCE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "301-852-8177",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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