NPIMap

Organization Active NPI

Esowoh Healthcare

  • Adolescent and Children Mental Health Clinic/Center
  • Baltimore, MD
National Provider Identifier
1750187043
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
ESOWOH HEALTHCARE
Practice address
2115 N Charles St
Baltimore, MD 21218-5760
Phone
(301) 653-8255
NPI assigned
Feb 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Abdul Malik FofanahNPI 1548979107
Title
Medical Director
Phone
(240) 441-7536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

2115 N Charles St
Baltimore, MD 21218-5760

Mailing address

2115 N Charles St
Baltimore, MD 21218-5760
Phone (301) 653-8255

National Provider Directory

National Provider Directory
Tax ID family
Esowoh Healthcare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1750187043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185760",
            "telephone_number": "301-653-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185760",
            "telephone_number": "301-653-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESOWOH HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "FOFANAH",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "MALIK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-441-7536"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.