NPIMap

Organization Active NPI

Covenant Psychiatric and Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1699135145
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R189544 Issued in MD
Legal business name
COVENANT PSYCHIATRIC AND MENTAL HEALTH SERVICES
Practice address
2607 Box Tree Dr
Upper Marlboro, MD 20774-9306
Phone
(202) 361-5925
NPI assigned
Feb 25, 2016
Last updated
Mar 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Folake Aloba, CRNP-PMHNPI 1255753489
Title
Owner
Phone
(240) 565-8797

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X R189544 MD Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X RN1018212 DC

Addresses

Primary practice location

2607 Box Tree Dr
Upper Marlboro, MD 20774-9306

Mailing address

9701 Apollo Dr
Suite 301
Largo, MD 20774-4783
Phone (240) 565-8797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160405001302 DC Part B Supplier - Clinic/Group Practice 1153628227 Receives reassigned benefits from 1 practitioner
Practice locations: Hyattsville, MD
O20171120000111 MD Part B Supplier - Clinic/Group Practice 1153628227 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Covenant Psychiatric and Mental Health Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1699135145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR",
            "address_2": "SUITE 301",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744783",
            "telephone_number": "240-565-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 BOX TREE DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749306",
            "telephone_number": "202-361-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT PSYCHIATRIC AND MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "ALOBA",
        "authorized_official_first_name": "FOLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-565-8797",
        "authorized_official_credential": "CRNP-PMH"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R189544",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1018212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.