Western Maryland Mental Health

Key facts

NPI

1699550772

Entity type

Organization (NPI type 2)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Legal business name

WESTERN MARYLAND MENTAL HEALTH

Practice address

7 W Main St
Middletown, MD 21769-8004

Phone

(301) 580-0626

NPI assigned

Aug 28, 2023

Organization subpart

No

Authorized official

Name

Selina Jones, NURSE PRACTITIONER

Title

FNP-BC-Pmhnp-BC

Phone

(301) 580-0626

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 28, 2023.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1699550772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WASHINGTON ST",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217698014",
            "telephone_number": "301-580-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W MAIN ST",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217698004",
            "telephone_number": "301-580-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MARYLAND MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SELINA",
        "authorized_official_title_or_position": "FNP-BC-PMHNP-BC",
        "authorized_official_telephone_number": "301-580-0626",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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