Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Modinat Oluwatoyin Fagbenro, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063061034

Modinat Oluwatoyin Fagbenro, PMHNP-BC is a Nurse Practitioner in Lutherville Timonium, Maryland. Qualified in 2019, 7 years ago. Practices with Mandm Behavioral Health Systems, a 3-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
7
Licensed in
MD
In the registry since
2019
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

22 W Padonia Rd Ste C252
Lutherville Timonium, MD 21093-2241
Phone: (410) 768-6088
Fax: (410) 768-6444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4105 Daylily Dr, Owings Mills, MD 21117-5034 — (410) 800-4471

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R210603 (MD)

Record details

NPI number1063061034
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedSeptember 11, 2019
Last updated in NPPESJanuary 20, 2026
Certification dateJanuary 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mandm Behavioral Health Systems — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Lutherville Timonium