Eb Psychiatric Associates

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

Legal business name

EB PSYCHIATRIC ASSOCIATES

Practice address

12530 Fairwood Pkwy Ste 102
Bowie, MD 20720-6357

Phone

(240) 615-5428

Fax

(240) 474-0244

NPI assigned

Nov 22, 2023

Organization subpart

No

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

Authorized official

Name

Cecilia E Tako, NP

Title

Owner

Phone

(240) 615-5428

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1952176695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12530 FAIRWOOD PKWY STE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207206357",
            "telephone_number": "240-615-5428",
            "fax_number": "240-474-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12530 FAIRWOOD PKWY STE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207206357",
            "telephone_number": "240-615-5428",
            "fax_number": "240-474-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EB PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "TAKO",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-615-5428",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in Bowie, MD
• Providers in Bowie, MD by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.