Hightower Behavioral Health
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Glen Burnie, MD
NPI 1972140069 · NPPES record last updated Jun 24, 2025
Key facts
- NPI
- 1972140069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- HIGHTOWER BEHAVIORAL HEALTH
- Practice address
- 420 Crain Hwy S Ste 3
Glen Burnie, MD 21061-3657 - Phone
- (410) 595-6199
- Fax
- (410) 684-5334
- NPI assigned
- Dec 8, 2019
- Organization subpart
- No
Authorized official
- Name
- Mary Ogunlowo-Omobhude
- Title
- President
- Phone
- (240) 602-7035
Subparts reporting this organization as parent 4
Corporate family (same tax ID) 4
Practitioners 9
-
Mabi T Ntumazah, PMHNP
-
Ida Mabelle Konchou, HHA
-
Juliana Bot Salau, LICSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200330003082 | DC | Part B Supplier - Clinic/Group Practice | 5799114591 |
Receives reassigned benefits from 1 practitioner Practice locations: Bowie, MD |
| O20200505000689 | MD | Part B Supplier - Clinic/Group Practice | 5799114591 |
Receives reassigned benefits from 6 practitioners Practice locations: Glen Burnie, MD |
National Provider Directory
- Tax ID family
- Hightower Behavioral Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
420 Crain Hwy S Ste 3
Glen Burnie, MD 21061-3657
Mailing address
4505 Blackbirds Folly LN
Bowie, MD 20720-5803
Phone (240) 602-7035
Other providers in Glen Burnie, MD
- Julia Nicole Hiep
- Hightower Behavioral Health
- Hightower Behavioral Health
- Hightower Behavioral Health
- Hightower Behavioral Health
- Frank Hill
- Terri Lynn Hill
- Jessica A Hilton
- Stacia M Hines
- Ilana Hipshman
All providers in Glen Burnie, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.