Healthcare Provider Details
I. General information
NPI: 1750238309
Provider Name (Legal Business Name): PSYCHFIT BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11325 PEMBROOKE SQ STE 114
WALDORF MD
20603-4807
US
IV. Provider business mailing address
13106 HAMPTON FARM LN
BRANDYWINE MD
20613-5812
US
V. Phone/Fax
- Phone: 443-415-6051
- Fax:
- Phone: 443-415-6051
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
LEWIS
EVANS
III
Title or Position: CEO
Credential: PHD, LCPC, CCPT-II
Phone: 202-441-7989