Provider Demographics
NPI:1891258323
Name:PASSION AND MERCY
Entity Type:Organization
Organization Name:PASSION AND MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRP COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-213-6423
Mailing Address - Street 1:15480 ANNAPOLIS ROAD 202
Mailing Address - Street 2:#187
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715
Mailing Address - Country:US
Mailing Address - Phone:301-213-6423
Mailing Address - Fax:
Practice Address - Street 1:11408 SCENERY PL
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-1349
Practice Address - Country:US
Practice Address - Phone:301-213-6423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1003379819Medicaid