MOA PSYCHIATRIC PRACTICE LLC NPI 1295507127

NPI Information

  • NPI: 1295507127
  • Provider Name: MOA PSYCHIATRIC PRACTICE LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 28 FLINT DR
    NORTH EAST, MD
    ZIP 21901
  • Phone: (240) 997-0287

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NPI Details

MOA PSYCHIATRIC PRACTICE LLC is a mental health (including community mental health center) clinic center in North East, MD. MOA PSYCHIATRIC PRACTICE LLC NPI is 1295507127. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

28 FLINT DR
NORTH EAST, MD
ZIP 21901-746
Phone: (240) 997-0287

The provider's authorized official is Olumide Mesioye .
The authorized official title is President and has the following contact phone number (240) 997-0287.

The enumeration date for this NPI number is 10/24/2023 and was last updated on 10/24/2023.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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: 3/30/2025

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