Active NPI
Gaithersburg Mental Health Associates, LLC
- Child & Adolescent Psychiatry Physician
- Gaithersburg, MD
National Provider Identifier
1700112083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- Legal business name
- GAITHERSBURG MENTAL HEALTH ASSOCIATES, LLC
- Practice address
- 915 Russell Ave
A
Gaithersburg, MD 20879-3202 - Phone
- (301) 948-1769
- Fax
- (301) 990-7111
- NPI assigned
- Oct 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sunny Singh
- Title
- Office Administrator
- Phone
- (301) 948-1769
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | Primary |
Addresses
Primary practice location
915 Russell Ave
A
Gaithersburg, MD 20879-3202
Mailing address
915 Russell Ave
A
Gaithersburg, MD 20879-3202
Phone (301) 948-1769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146691700 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
915 Russell Ave
Gaithersburg, MD 20879
Phone (301) 948-1769
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Gaithersburg, MD
- NPI 1417950031
-
- Social Worker
- Gaithersburg, MD
- NPI 1912982869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1292544000000",
"number": "1700112083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 RUSSELL AVE",
"address_2": "A",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793202",
"telephone_number": "301-948-1769",
"fax_number": "301-990-7111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 RUSSELL AVE",
"address_2": "A",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793202",
"telephone_number": "301-948-1769",
"fax_number": "301-990-7111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GAITHERSBURG MENTAL HEALTH ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-21",
"last_updated": "2010-12-17",
"status": "A",
"authorized_official_last_name": "SINGH",
"authorized_official_first_name": "SUNNY",
"authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
"authorized_official_telephone_number": "301-948-1769"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "146691700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gaithersburg, MD
- Gaithersburg Dental Associate PA
- Gaithersburg Dental Associates
- Gaithersburg Durable Medical Equipment
- Gaithersburg Foot and Ankle Surgery Center
- Gaithersburg Imaging Center, LLC
- Gaithersburg Modern Dentistry, LLC
- Gaithersburg Ortho LLC
- Gaithersburg Pharmacy, LLC
- Gaithersburg RX LLC
- Gaithersburg Wellness Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.