Provider Demographics
NPI:1790393056
Name:SEAMAGTEK HEALTHCARE SERVICES, L.L.C.
Entity Type:Organization
Organization Name:SEAMAGTEK HEALTHCARE SERVICES, L.L.C.
Other - Org Name:MD TELEPSYCHIATRIC CENTER, L.L.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DR. ERNESTINE
Authorized Official - Middle Name:MBI
Authorized Official - Last Name:ENOHMBI DNP, CRNP-FAMILY, CRNP-PMH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP-PMH
Authorized Official - Phone:240-349-6300
Mailing Address - Street 1:13807 CLARKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9437
Mailing Address - Country:US
Mailing Address - Phone:240-349-6300
Mailing Address - Fax:979-606-0062
Practice Address - Street 1:4600 POWDER MILL RD STE 450-W
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2675
Practice Address - Country:US
Practice Address - Phone:240-349-6300
Practice Address - Fax:979-606-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1790393056Medicaid
MD1124654652Medicaid