Guardian Mental and Behavioral Health Services LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GUARDIAN MENTAL AND BEHAVIORAL HEALTH SERVICES LLC

Practice address

1611 Pebble Beach Dr
Bowie, MD 20721-2375

Phone

(240) 462-9940

NPI assigned

Aug 19, 2021

Organization subpart

No

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

Authorized official

Name

Chinyere Otuya, NURSE PRACTITIONERNPI 1134482615

Title

Ceo

Phone

(240) 462-9940

Specialties & licenses 3

Addresses

Other names 1

• GUARDIAN MENTAL AND BEHAVIORAL HEALTH SERVICES LLC Other name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chinyere Lois Otuya, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Largo, MD
  • NPI 1134482615

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1821764705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PEBBLE BEACH DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212375",
            "telephone_number": "240-462-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 PEBBLE BEACH DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212375",
            "telephone_number": "240-462-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN MENTAL AND BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "OTUYA",
        "authorized_official_first_name": "CHINYERE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-462-9940",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GUARDIAN MENTAL AND BEHAVIORAL HEALTH SERVICES LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychiatry Physician in Bowie, MD
• Providers in Bowie, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.