Organization Active NPI

Holystik Behaviorah Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Marlboro, MD
National Provider Identifier
1710715685
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HOLYSTIK BEHAVIORAH HEALTH
Practice address
210 Castleton PL
Upper Marlboro, MD 20774-1446
Phone
(301) 219-1046
NPI assigned
Jul 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Philip Oseghale
Title
President
Phone
(301) 219-1046

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

210 Castleton PL
Upper Marlboro, MD 20774-1446

Mailing address

210 Castleton PL
Upper Marlboro, MD 20774-1446
Phone (301) 219-1046

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1710715685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CASTLETON PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741446",
            "telephone_number": "301-219-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CASTLETON PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741446",
            "telephone_number": "301-219-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLYSTIK BEHAVIORAH HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "OSEGHALE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-219-1046"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 Jul 23, 2024; 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.