NPIMap

Organization Active NPI

Bayside Behavioral Health Clinic of Annapolis

  • Clinical Social Worker
  • Annapolis, MD
National Provider Identifier
1700137643
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10949 Issued in MD
Legal business name
BAYSIDE BEHAVIORAL HEALTH CLINIC OF ANNAPOLIS
Practice address
134 Holiday CT
Suite 302
Annapolis, MD 21401-7008
Phone
(410) 266-1600
NPI assigned
Oct 1, 2012
Last updated
Oct 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Melanie OgunmefunNPI 1033177712
Title
Medical Director
Phone
(410) 266-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 10949 MD Primary

Addresses

Primary practice location

134 Holiday CT
Suite 302
Annapolis, MD 21401-7008

Mailing address

PO Box 225
Pasadena, MD 21123-0225

National Provider Directory

National Provider Directory
Tax ID family
Bayside Behavioral Health Clinic of Annapolis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

134 Holiday Ct
Ste 302
Annapolis, MD 21401
Phone (410) 224-2000

Practitioners & affiliated clinicians

Practitioners 2

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": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1700137643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 225",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211230225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HOLIDAY CT",
            "address_2": "SUITE 302",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017008",
            "telephone_number": "410-266-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE BEHAVIORAL HEALTH CLINIC OF ANNAPOLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "OGUNMEFUN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-266-1600"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.