NPIMap

Organization Active NPI

Lifespan Behavioral Health Services PC

  • Psychiatry Physician
  • Greenbelt, MD
National Provider Identifier
1881233872
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LIFESPAN BEHAVIORAL HEALTH SERVICES PC
Practice address
7474 Greenway Center Dr Ste 700a
Greenbelt, MD 20770-3523
Phone
(301) 982-3437
NPI assigned
Dec 23, 2019
Last updated
Dec 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Carolyn Reidy
Title
Office Administrator
Phone
(845) 590-3230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

7474 Greenway Center Dr Ste 700a
Greenbelt, MD 20770-3523

Mailing address

2705 Silver Hammer Way
Brookeville, MD 20833-3244

Other practice location 1

3416 Olandwood Ct Ste 201
Olney, MD 20832-1373
Phone (301) 969-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200221000259 MD Part B Supplier - Clinic/Group Practice 4082041637 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Frederick, MD
O20200221000871 DC Part B Supplier - Clinic/Group Practice 4082041637 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
Practice locations: Greenbelt, MD; Olney, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3460 Olney Laytonsville Rd
Ste 212
Olney, MD 20832
Phone (301) 982-3437

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1881233872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 SILVER HAMMER WAY",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208333244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR STE 700A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703523",
            "telephone_number": "301-982-3437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3416 Olandwood Ct Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "MD",
            "postal_code": "208321373",
            "country_code": "US",
            "telephone_number": "301-969-4060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESPAN BEHAVIORAL HEALTH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "REIDY",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "845-590-3230"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.