Healthcare Provider Details

I. General information

NPI: 1316870090
Provider Name (Legal Business Name): PENUEL BEHAVIORAL HEALTH SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 W WARD RD STE 201
DUNKIRK MD
20754-3047
US

IV. Provider business mailing address

3140 W WARD RD STE 201
DUNKIRK MD
20754-3047
US

V. Phone/Fax

Practice location:
  • Phone: 301-832-4847
  • Fax:
Mailing address:
  • Phone: 301-832-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: OLABIMPE OLOJO
Title or Position: CLINICAL
Credential: CRNP
Phone: 301-832-4847