Omega Behavioral Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OMEGA BEHAVIORAL CLINIC LLC

Practice address

4500 Forbes Blvd Ste 200
Lanham, MD 20706-6316

Phone

(301) 520-6782

NPI assigned

Jul 9, 2024

Organization subpart

No

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

Authorized official

Name

Olufunke Taiwo, CRNPNPI 1861058570

Title

Nurse Practioner

Phone

(301) 520-6782

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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

• Olufunke Abidemi Taiwo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
  • NPI 1861058570
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1841037728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 NORTHERN LIGHTS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746049",
            "telephone_number": "301-520-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 FORBES BLVD STE 200",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066316",
            "telephone_number": "301-520-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA BEHAVIORAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "TAIWO",
        "authorized_official_first_name": "OLUFUNKE",
        "authorized_official_title_or_position": "NURSE PRACTIONER",
        "authorized_official_telephone_number": "301-520-6782",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adeola Olukoya
• Chinonyerem Olumba
• Elizabeth Ire Olumese
• Pauline Oluwo, NP
• Aisha Mercy Omaghomi
• Ademola Clement Omisakin Jr., LGPC
• Oluwatobi Omobo, NP
• Olufunke Omomo
• Adenike Titilayo Omosebi
• Ayodele Omoteye, HHA

• Psychiatric/Mental Health Nurse Practitioner in Lanham, MD
• Providers in Lanham, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.