Mentor-Maryland

LBN: Mentor-Maryland
Mentor-Maryland is an health care organization with primary practice located at 4200 Forbes Boulevard Suite 100, Lanham MD 20706. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Mentor-Maryland can be contacted via phone (301) 459-3057, or through Simmons, Carol Ivy via phone (410) 455-4600.

Contact Information

Primary practice address
4200 Forbes Boulevard Suite 100 Lanham MD 20706
Phone: (301) 459-3057
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Simmons, Carol Ivy PH.D., LCSW-C
Phone: (410) 455-4600

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X MH-2278 Maryland

Profile Details

NPI number 1023544285
LBN Legal business name Mentor-Maryland
DBA Doing business as
Authorized official Simmons, Carol Ivy PH.D., LCSW-C
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2017
Last updated May 10th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023544285 NPPES
Maryland MEDICAID 056668

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