Healthcare Provider Details

I. General information

NPI: 1568308757
Provider Name (Legal Business Name): BREAKING MENTAL BARRIERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4303 W VILLAGE AVE APT 3002
CAMP SPRINGS MD
20746-5232
US

IV. Provider business mailing address

4303 W VILLAGE AVE APT 3002
CAMP SPRINGS MD
20746-5232
US

V. Phone/Fax

Practice location:
  • Phone: 202-630-4446
  • Fax:
Mailing address:
  • Phone: 202-630-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRANDON RIVERS
Title or Position: OWNER
Credential: PSYD
Phone: 240-604-2571