MEDICARE: PSYCHFIT BEHAVIORAL HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1750238309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHFIT BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	13106 HAMPTON FARM LN
Second Line	:
City	:	BRANDYWINE
State	:	MD
Zip	:	20613-5812
Country	:	US
Telephone Number	:	443-415-6051
Fax Number	:

Provider Business Practice Location Address
First Line	:	11325 PEMBROOKE SQ STE 114
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20603-4807
Country	:	US
Telephone Number	:	443-415-6051
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBERT LEWIS EVANS III
Credential	:	PHD, LCPC, CCPT-II
Telephone Number	:	202-441-7989

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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