Healthcare Provider Details

I. General information

NPI: 1720604960
Provider Name (Legal Business Name): URBAN INSTITUTE OF MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8865 STANFORD BLVD STE 202
COLUMBIA MD
21045-5422
US

IV. Provider business mailing address

397 CARRONADE WAY
ARNOLD MD
21012-2362
US

V. Phone/Fax

Practice location:
  • Phone: 443-995-5984
  • Fax:
Mailing address:
  • Phone: 443-995-5984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: OCTAVIA MARIE BROWN
Title or Position: CEO
Credential: LCSW-C
Phone: 443-995-5984