ANTHEM BEHAVIORAL HEALTH, LLC
NPI 1417736091
Nurse Practitioner - Psychiatric/Mental Health in Bel Air, MD
About Anthem Behavioral Health, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTHEM BEHAVIORAL HEALTH, LLC (NPI 1417736091) is a healthcare organization registered as a psychiatric/mental health in Bel Air, Maryland and active in the NPI registry since September 2023. The organization lists Jennifer Petrik, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
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)
Anthem Behavioral Health, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Anthem Behavioral Health, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Anthem Behavioral Health, LLC's NPI number?
The NPI number for Anthem Behavioral Health, LLC is 1417736091. It was assigned to this organization in the NPPES registry on September 25, 2023.
Where is Anthem Behavioral Health, LLC located?
Anthem Behavioral Health, LLC is located at 404 N Hickory Ave, Bel Air, MD 21014. The listed phone number is (410) 459-7699.
What is Anthem Behavioral Health, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Anthem Behavioral Health, LLC enrolled in Medicare?
Yes. Anthem Behavioral Health, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Anthem Behavioral Health, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Anthem Behavioral Health, LLC, in Clinical Social Worker and Nurse Practitioner. 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Anthem Behavioral Health, LLC was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Anthem Behavioral Health, Llc · NPI 1417736091
Psychiatric/Mental Health organization in Bel Air, Maryland. Organization record, active in the CMS NPPES registry since September 25, 2023.
## Identity
- **NPI:** 1417736091 (Entity type: Organization)
- **Enumerated:** September 25, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jennifer Petrik, CEO
## Practice location
- **Address:** 404 N HICKORY AVE, Bel Air, MD 21014-3227
- **Phone:** (410) 459-7699
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (2), Nurse Practitioner (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1417736091) · Data from the CMS NPPES public registry.