Provider Demographics
NPI:1740143759
Name:HUMANISTIC BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:HUMANISTIC BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:SUEZZETTE
Authorized Official - Last Name:BRISTOL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-780-4747
Mailing Address - Street 1:9861 BROKEN LAND PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3031
Mailing Address - Country:US
Mailing Address - Phone:443-780-4747
Mailing Address - Fax:
Practice Address - Street 1:9861 BROKEN LAND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3031
Practice Address - Country:US
Practice Address - Phone:443-780-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty