Harborside Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HARBORSIDE BEHAVIORAL HEALTH, LLC

Practice address

41625 Park Ave
Leonardtown, MD 20650-3894

Phone

(301) 494-1009

Fax

(970) 296-5636

NPI assigned

Feb 12, 2019

Organization subpart

No

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

Authorized official

Name

Sabrina Sepulveda, CRNP-PMH

Title

Owner

Phone

(301) 494-1009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1972069201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452",
            "city": "VALLEY LEE",
            "state": "MD",
            "postal_code": "206920452",
            "telephone_number": "443-401-1376",
            "fax_number": "970-296-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41625 PARK AVE",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503894",
            "telephone_number": "301-494-1009",
            "fax_number": "970-296-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-494-1009",
        "authorized_official_credential": "CRNP-PMH"
    },
    "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": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Leonardtown, MD
• Providers in Leonardtown, 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 Oct 14, 2022; 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.