Healthcare Provider Details

I. General information

NPI: 1447178769
Provider Name (Legal Business Name): MD BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MITCHELLVILLE RD STE A414
BOWIE MD
20716-3142
US

IV. Provider business mailing address

21880 MILLISON LN STE B
LEXINGTON PARK MD
20653-5513
US

V. Phone/Fax

Practice location:
  • Phone: 301-249-8100
  • Fax: 301-390-8086
Mailing address:
  • Phone: 301-249-8100
  • Fax: 301-390-8086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AYOKUNLE OLULEYE
Title or Position: CEO
Credential:
Phone: 443-274-7314