NPIMap

Organization Active NPI

KP Optimum Care Behavioral Services

  • Community/Behavioral Health Agency
  • Laurel, MD
National Provider Identifier
1861081002
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KP OPTIMUM CARE BEHAVIORAL SERVICES
Practice address
370 Main St
Laurel, MD 20707-4133
Phone
(301) 641-2284
NPI assigned
Jan 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Authorized official

Name
Katumu Frances Pettiquoi, LCPCNPI 1508022831
Title
Ceo
Phone
(301) 641-2284

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

370 Main St
Laurel, MD 20707-4133

Mailing address

PO Box 114
Laurel, MD 20725-0114

Other names 1

  • KP Optimum Care Other name

National Provider Directory

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": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1861081002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207250114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074133",
            "telephone_number": "301-641-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KP OPTIMUM CARE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "PETTIQUOI",
        "authorized_official_first_name": "KATUMU",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-641-2284",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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": "KP Optimum Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.