| Boundless Mental Health | |
|
6130 Oxon Hill Rd Ste 204 Oxon Hill MD 20745-3168 | |
| (240) 791-4549 | |
| (240) 969-3001 |
| Full Name | Boundless Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 6130 Oxon Hill Rd Ste 204, Oxon Hill, Maryland |
| Authorized Official Name and Position | Olatunji Folawewo (OWNER/PROVIDER) |
| Authorized Official Contact | 3012545618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boundless Mental Health 1215 Stockport Ct Bowie MD 20721-1836 Ph: (301) 254-5618 | Boundless Mental Health 6130 Oxon Hill Rd Ste 204 Oxon Hill MD 20745-3168 Ph: (240) 791-4549 |
| NPI Number | 1306573761 |
|---|---|
| Provider Enumeration Date | 08/05/2022 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Medicare PECOS PAC ID | 7214310317 |
|---|---|
| Medicare Enrollment ID | O20220823002498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306573761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Olatunji Folawewo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710473087 PECOS PAC ID: 5991053258 Enrollment ID: I20180816000030 |
| Provider Name | Chante Kelliebrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477242188 PECOS PAC ID: 4688029531 Enrollment ID: I20231012000629 |
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