PLATINUM BEHAVIORAL HEALTH LLC NPI 1083244354

NPI Information

NPI: 1083244354
Provider Name: PLATINUM BEHAVIORAL HEALTH LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
1125 WEST ST STE 235
ANNAPOLIS, MD
ZIP 21401
Phone: (240) 353-1018
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PLATINUM BEHAVIORAL HEALTH LLC is a psychiatric/mental health nurse practitioner in Annapolis, MD. PLATINUM BEHAVIORAL HEALTH LLC NPI is 1083244354. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1125 WEST ST STE 235
ANNAPOLIS, MD
ZIP 21401-198
Phone: (240) 353-1018

The provider's authorized official is Malcolm Cook .
The authorized official title is Nurse Practitioner and has the following contact phone number (240) 353-1018.

The enumeration date for this NPI number is 1/24/2020 and was last updated on 10/26/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15880647208	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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