NPI Code Detail JSON Logo

1265040653 NPI number — BEHAVIORAL HEALTH AND THERAPY CLINIC

NPI Number: 1265040653
Health Care Provider/Practitioner: BEHAVIORAL HEALTH AND THERAPY CLINIC

Information about “1265040653” NPI (BEHAVIORAL HEALTH AND THERAPY CLINIC) exists in 1265040653 in HTML format HTML  |  1265040653 in plain Text format TXT  |  1265040653 in PDF (Portable Document Format) PDF  |  1265040653 in an XML format XML  formats.

NPI Number : 1265040653 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265040653",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BEHAVIORAL HEALTH AND THERAPY CLINIC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12501 PROSPERITY DR STE 330",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SILVER SPRING",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20904-1655",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "240-899-5315",
    "MailingAddressFaxNumber": "240-645-4013",
    "FirstLinePracticeLocationAddress": "12501 PROSPERITY DR STE 330",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SILVER SPRING",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20904-1655",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-899-5315",
    "PracticeLocationAddressFaxNumber": "240-645-4013",
    "EnumerationDate": "07/21/2020",
    "LastUpdateDate": "10/02/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "AGBOR",
    "AuthorizedOfficialFirstName": "AMAOBI",
    "AuthorizedOfficialMiddleName": "HARDY",
    "AuthorizedOfficialTitle": "AUTHORIZED OFFICIAL",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "301-693-2207",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.