Healthcare Provider Details

I. General information

NPI: 1922945690
Provider Name (Legal Business Name): OMI PSYCHIATRY AND TMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 LIGHTHOUSE PT E STE 260
BALTIMORE MD
21224-4791
US

IV. Provider business mailing address

2700 LIGHTHOUSE PT E STE 260
BALTIMORE MD
21224-4791
US

V. Phone/Fax

Practice location:
  • Phone: 410-801-6575
  • Fax: 410-801-9672
Mailing address:
  • Phone: 410-801-6575
  • Fax: 410-801-9672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ADERONKE OLUYEMISI OMOTADE
Title or Position: OWNER
Credential:
Phone: 410-801-6575