Anthem Behavioral Health, LLC
NPI 1417736091ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Bel Air, MD
Nurse Practitioner, Psych/Mental Health in Bel Air, Maryland, registered in NPPES in September 2023. The authorized official on file is Jennifer Petrik, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417736091 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 25, 2023 |
| Last updated in NPPES | Feb 13, 2025 |
| Certified by provider | Feb 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | — | — |
| Counselor, Mental Health | 101YM0800X | — | — |
| Counselor, Professional | 101YP2500X | — | — |
| Social Worker, Clinical | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MD) |
|---|
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