MEDICARE: FREDERICK INTEGRATIVE METABOLIC PSYCHIATRY AND COUNSELING, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103T00000X	Psychologist
3	103TC1900X	Counseling Psychologist
4	103TP2701X	Group Psychotherapy Psychologist
5	104100000X	Social Worker
6	133N00000X	Nutritionist
7	171400000X	Health & Wellness Coach
8	174H00000X	Health Educator
9	202D00000X	Integrative Medicine Physician
10	2084P0804X	Child & Adolescent Psychiatry Physician
11	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
12	261QM0855X	Adolescent and Children Mental Health Clinic/Center
13	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
14	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1043101975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK INTEGRATIVE METABOLIC PSYCHIATRY AND COUNSELING, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 1485
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-0485
Country	:	US
Telephone Number	:	240-422-5695
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 W 7TH ST UNIT 1485
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-7517
Country	:	US
Telephone Number	:	240-422-5695
Fax Number	:

Authorized Official
Title or Position	:	CHIEF CLINICAL OFFICER
Name	:	MS. UMU COOMBER
Credential	:	ARNP, BC-PMHNP
Telephone Number	:	240-422-5695

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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