Superbloom Psychiatry LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SUPERBLOOM PSYCHIATRY LLC

Practice address

301 Main St Ste 2D
Reisterstown, MD 21136-1957

Phone

(443) 203-8613

NPI assigned

Jul 18, 2024

Last updated

Jul 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Meredith West, CRNPNPI 1720705122

Title

Psychiatric Nurse Practitioner

Phone

(912) 596-7573

Specialties & licenses 1

Addresses

Locations

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.

• Meredith West, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Media, PA
  • NPI 1720705122
  NPD Authorized official

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1790523173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SAXONY CT",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083319",
            "telephone_number": "912-596-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST STE 2D",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361957",
            "telephone_number": "443-203-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERBLOOM PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "912-596-7573",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ronald Surdin, O.D.

• Adult Mental Health Clinic/Center in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Adult Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.