Healthcare Provider Details
I. General information
NPI: 1528987997
Provider Name (Legal Business Name): METROLITAN BEHAVIORAL AND MENTAL HLTH NP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1313 SOUTHERN SPRINGS LN
UPPER MARLBORO MD
20774-6062
US
IV. Provider business mailing address
1313 SOUTHERN SPRINGS LN
UPPER MARLBORO MD
20774-6062
US
V. Phone/Fax
- Phone: 240-505-0355
- Fax: 240-505-0355
- Phone: 240-505-0355
- Fax: 240-505-0355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AWA
DIAKITE
Title or Position: OWNER
Credential: PMHNP
Phone: 240-505-0355