NPIMap

Organization Active NPI

Providence Mental Health

  • Psychiatry Physician
  • Timonium, MD
National Provider Identifier
1689133183
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PROVIDENCE MENTAL HEALTH
Practice address
2345 York Rd Ste 201
Timonium, MD 21093-2279
Phone
(571) 331-8617
NPI assigned
Mar 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Authorized official

Name
Dr. Abdolazim Shahsavar, MDNPI 1598064859
Title
Physician and the Practice Owner
Phone
(571) 331-8617

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2345 York Rd Ste 201
Timonium, MD 21093-2279

Mailing address

527 Chatterton Rd
Timonium, MD 21093-1934
Phone (571) 331-8617

National Provider Directory

National Provider Directory

Locations

2345 York Rd
Ste 201
Timonium, MD 21093
Phone (571) 331-8617

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": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1689133183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 CHATTERTON RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210931934",
            "telephone_number": "571-331-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 YORK RD STE 201",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932279",
            "telephone_number": "571-331-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "SHAHSAVAR",
        "authorized_official_first_name": "ABDOLAZIM",
        "authorized_official_title_or_position": "PHYSICIAN AND THE PRACTICE OWNER",
        "authorized_official_telephone_number": "571-331-8617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.