Advantage Psychiatric Services LLC
Organization Active NPI Clinic/Center · Havre de Grace, MD
NPI 1700515236 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1700515236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ADVANTAGE PSYCHIATRIC SERVICES LLC
- Practice address
- 253 Lewis LN Ste 101
Havre de Grace, MD 21078-3755 - Phone
- (410) 686-3629
- Fax
- (410) 780-7178
- NPI assigned
- Jun 9, 2022
- Organization subpart
- No
Authorized official
- Name
- Cynthia Lynn Pixton
- Title
- Ceo
- Phone
- (410) 686-3629
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 7
Practitioners 28
-
Adebola Abe-Fapohunda, PMHNP-BC
-
Abdulhafiz A Ahmed, M.D.
-
Angelina Argyle, LCSW-C
-
Ethel Ann Bakke, LPC, NCC, LMHC, CAP
-
Lynn Bass, LCPC
-
Amanda Emmons, LCPC
-
Doris Stacy Fair, LCPC
-
Frances Horzempa, LCSW-C
-
Samantha Jones, PMHNP
-
Katelynn Mae Liptak, LCSW-C
-
Ronald Tyler Montgomery, LGPC
-
Lydia Moore, LCPC
-
Jartu Nylander, PMHNP-BC
-
Obinna Chukwuebuka Okonkwo, PMHNP-BC
-
Amanda Page, LCSW- C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190326001310 | MD | Part B Supplier - Clinic/Group Practice | 2860732039 |
Receives reassigned benefits from 27 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Nottingham, MD; Prince Frederick, MD; Havre de Grace, MD; Elkton, MD; Annapolis, MD |
National Provider Directory
- Tax ID family
- Advantage Psychiatric Services LLC
Locations
2001 Commerce Park Dr
Ste A
Annapolis, MD 21401
1114 Benfield Blvd
Ste H
Millersville, MD 21108
Phone (410) 686-3626
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
253 Lewis LN Ste 101
Havre de Grace, MD 21078-3755
Mailing address
5024 Campbell Blvd Ste a
Nottingham, MD 21236-5974
Phone (410) 686-3629
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220512567 | Other | MD | LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | www.information@advantagepsyc.com | Direct |
Other providers in Havre de Grace, MD
- John Acquaviva Jr.
- Angelina Addae-Mensah
- Adfinitas Health at Upper Chesapeake Harford Memorial LLC
- Advanced Pain Management Specialists, LLC
- Advanced Pain Management Specialists, LLC
- Agape Physical Therapy & Sports Rehabilitation LP
- Anna Lenore Agnew
- Sumera Ali
- Vida Amevinya
- Bridget Nicole Anders
All providers in Havre de Grace, MD · Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.