| Mighty Behavioral Health Services | |
|
11 E Lexington St Ste 600 Baltimore MD 21202-1711 | |
| (443) 226-3330 | |
| (410) 826-3855 |
| Full Name | Mighty Behavioral Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 E Lexington St Ste 600, Baltimore, Maryland |
| Authorized Official Name and Position | Bisrat A Mesfin (CEO) |
| Authorized Official Contact | 5129472747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mighty Behavioral Health Services 11 E Lexington St Ste 400 Baltimore MD 21202-1723 Ph: (443) 708-5162 | Mighty Behavioral Health Services 11 E Lexington St Ste 600 Baltimore MD 21202-1711 Ph: (443) 226-3330 |
| NPI Number | 1720569882 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 07/24/2020 |
| Medicare PECOS PAC ID | 2163760653 |
|---|---|
| Medicare Enrollment ID | O20190207001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720569882 | NPI | - | NPPES |
| 742010200 | Medicaid | MD |
| Provider Name | Bisrat A Mesfin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770992596 PECOS PAC ID: 7719209626 Enrollment ID: I20141204000360 |
| Provider Name | Tajudeen Omodeoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817373 PECOS PAC ID: 9537402391 Enrollment ID: I20190517002182 |
| Provider Name | Brittany Guy Van Devander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487207338 PECOS PAC ID: 5597097972 Enrollment ID: I20191105000455 |
| Provider Name | Yohannes Berihun Tegegne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013516590 PECOS PAC ID: 2163836974 Enrollment ID: I20210205000493 |
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