INNERBLOOM MENTAL HEALTH CLINICS LLC
NPI 1104792787
Nurse Practitioner - Psychiatric/Mental Health in Waldorf, MD
About Innerbloom Mental Health Clinics Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INNERBLOOM MENTAL HEALTH CLINICS LLC (NPI 1104792787) is a healthcare organization registered as a psychiatric/mental health in Waldorf, Maryland and active in the NPI registry since October 2025. The organization lists Rahmot Raji, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Innerbloom Mental Health Clinics Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Innerbloom Mental Health Clinics LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Innerbloom Mental Health Clinics LLC's NPI number?
The NPI number for Innerbloom Mental Health Clinics LLC is 1104792787. It was assigned to this organization in the NPPES registry on October 13, 2025.
Where is Innerbloom Mental Health Clinics LLC located?
Innerbloom Mental Health Clinics LLC is located at 3460 Old Washington Rd Ste 203A, Waldorf, MD 20602. The listed phone number is (240) 421-4164.
What is Innerbloom Mental Health Clinics LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Innerbloom Mental Health Clinics LLC enrolled in Medicare?
Yes. Innerbloom Mental Health Clinics LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Innerbloom Mental Health Clinics LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Innerbloom Mental Health Clinics LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Innerbloom Mental Health Clinics LLC was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Innerbloom Mental Health Clinics Llc · NPI 1104792787
Psychiatric/Mental Health organization in Waldorf, Maryland. Organization record, active in the CMS NPPES registry since October 13, 2025.
## Identity
- **NPI:** 1104792787 (Entity type: Organization)
- **Enumerated:** October 13, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Rahmot Raji, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 3460 OLD WASHINGTON RD STE 203A, Waldorf, MD 20602-3243
- **Phone:** (240) 421-4164
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104792787) · Data from the CMS NPPES public registry.