Healthcare Provider Details

I. General information

NPI: 1992198139
Provider Name (Legal Business Name): ARI MENTAL HEALTH GROUP PRACTISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 MAIN ST
LAUREL MD
20707-4127
US

IV. Provider business mailing address

419 MAIN ST
LAUREL MD
20707-4127
US

V. Phone/Fax

Practice location:
  • Phone: 301-490-5551
  • Fax: 301-490-2517
Mailing address:
  • Phone: 301-490-5551
  • Fax: 301-490-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number905320
License Number StateMD

VIII. Authorized Official

Name: MARIA MACCHIO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 410-923-6700