Stephen Lyndell Mann, LGP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

13400 Edgemeade Rd
Upper Marlboro, MD 20772-8088

Phone

(240) 681-6000

Fax

(301) 579-2400

NPI assigned

Jan 17, 2020

Last updated

Jan 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 24, 2026 through Apr 24, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1689204695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 CHISWELL LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011115",
            "telephone_number": "410-370-0202",
            "fax_number": "301-579-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 EDGEMEADE RD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728088",
            "telephone_number": "240-681-6000",
            "fax_number": "301-579-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "STEPHEN",
        "middle_name": "LYNDELL",
        "credential": "LGP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED GRADUATE PROFESSIONAL COUNSELOR",
            "identifier": "10004",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Upper Marlboro, MD
• Providers in Upper Marlboro, 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 Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.