MY COVENANT PLACE NPI 1164853669

NPI Information

  • NPI: 1164853669
  • Provider Name: MY COVENANT PLACE
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Address: 9701 APOLLO DR STE 4114TH
    LARGO, MD
    ZIP 20774
  • Phone: (301) 577-7307

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NPI Details

MY COVENANT PLACE is a community behavioral health in Largo, MD. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MY COVENANT PLACE NPI is 1164853669. The provider is registered as an organization entity type.

The provider's business location address is:

9701 APOLLO DR STE 4114TH
LARGO, MD
ZIP 20774-783
Phone: (301) 577-7307
Fax: (301) 476-0076

The provider's authorized official is Latisha Carter .
The authorized official title is Ceo/executive Director and has the following contact phone number (301) 577-7307.

The enumeration date for this NPI number is 12/9/2013 and was last updated on 1/9/2023.

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
1251S00000XCommunity/Behavioral HealthMARYLANDYes

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
119125M99MEDICAIDMARYLAND

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: 11/21/2025

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