MEDICARE: M&M BEHAVIORAL HEALTH SYSTEMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	251S00000X	Community/Behavioral Health Agency
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1881219848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M&M BEHAVIORAL HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	4105 DAYLILY DR
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-5034
Country	:	US
Telephone Number	:	443-672-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 W PADONIA RD STE C252
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-2241
Country	:	US
Telephone Number	:	410-800-4471
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	EDWARD MASON
Credential	:	CREDENTIALING MANAGE
Telephone Number	:	530-868-6944

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	01/20/2026

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