NPIMap

Organization Active NPI

Primal Point LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
National Provider Identifier
1720797582
Registry record updated Nov 26, 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
PRIMAL POINT LLC
Practice address
8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone
(410) 870-1590
NPI assigned
Nov 21, 2022
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Ngufor Fube Divine, PMHNPNPI 1669197208
Title
President
Phone
(410) 870-1590

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

8713 Harford Rd Ste 102
Parkville, MD 21234-4650

Mailing address

8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone (410) 870-1590

Other practice location 1

9001 Harford Rd
Parkville, MD 21234-4029
Phone (410) 870-1590

National Provider Directory

National Provider Directory
Tax ID family
Primal Point LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1720797582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "410-870-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "410-870-1590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9001 Harford Rd",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212344029",
            "country_code": "US",
            "telephone_number": "410-870-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMAL POINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "FUBE DIVINE",
        "authorized_official_first_name": "NGUFOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-870-1590",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.