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General NPI Number Information
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NPI Number | 1003337429
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Entity Type | Organization
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Legal Business Name | KMH MENTAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 3916 MERTFORD ST
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City | KENSINGTON
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State | MD
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Zip | 20895-2010
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Country | US
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Telephone | 202-680-4080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 664
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City | KENSINGTON
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State | MD
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Zip | 20895-0664
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Country | US
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Telephone | 202-680-4080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE MANSFIELD-HOULE
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Credential | PSY.D.
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Telephone | 202-680-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 13103
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License Number State | MD
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