MEDICARE: PASSION AND MERCY

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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891258323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSION AND MERCY

Provider Business Mailing Address
First Line	:	15480 ANNAPOLIS ROAD 202
Second Line	:	#187
City	:	BOWIE
State	:	MD
Zip	:	20715
Country	:	US
Telephone Number	:	301-213-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	11408 SCENERY PL
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-1349
Country	:	US
Telephone Number	:	301-213-6423
Fax Number	:

Authorized Official
Title or Position	:	PRP COUNSELOR
Name	:	PAMELA D MURPHY
Credential	:
Telephone Number	:	301-213-6423

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	04/11/2019

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Directions to “PASSION AND MERCY ” Practice Location

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