PRIME BEHAVIORAL HEALTH LLC
NPI 1164990818
Clinic/Center - Mental Health (Including Community Mental Health Center) in Laurel, MD
About Prime Behavioral Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME BEHAVIORAL HEALTH LLC (NPI 1164990818) is a healthcare organization registered as a mental health (including community mental health center) in Laurel, Maryland and active in the NPI registry since November 2018. The organization holds a CLIA Waiver certificate valid through June 17, 2027 and lists Julius Fomengia, Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Behavioral Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Prime Behavioral Health LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D2167895
Prime Behavioral Health LLC · Laurel, MDFrequently 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 Prime Behavioral Health LLC's NPI number?
The NPI number for Prime Behavioral Health LLC is 1164990818. It was assigned to this organization in the NPPES registry on November 10, 2018.
Where is Prime Behavioral Health LLC located?
Prime Behavioral Health LLC is located at 13994 Baltimore Ave Ste 102, Laurel, MD 20707. The listed phone number is (240) 463-3357.
What is Prime Behavioral Health LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Prime Behavioral Health LLC enrolled in Medicare?
Yes. Prime Behavioral Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Behavioral Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Prime Behavioral Health 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Prime Behavioral Health LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2167895) is associated with this NPI, valid through June 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Prime Behavioral Health LLC was last updated on November 10, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# Prime Behavioral Health Llc · NPI 1164990818
Mental Health (Including Community Mental Health Center) organization in Laurel, Maryland. Organization record, active in the CMS NPPES registry since November 10, 2018.
## Identity
- **NPI:** 1164990818 (Entity type: Organization)
- **Enumerated:** November 10, 2018
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Julius Fomengia, PARTNER
## Practice location
- **Address:** 13994 BALTIMORE AVE STE 102, Laurel, MD 20707-5087
- **Phone:** (240) 463-3357
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 10, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164990818) · Data from the CMS NPPES public registry.