Addiction Wellness Center PA LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ADDICTION WELLNESS CENTER PA LLC

Practice address

4755 Linglestown Rd Ste 402B
Harrisburg, PA 17112-8508

Phone

(667) 367-8357

NPI assigned

May 31, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alex Henderson

Title

Executive Director

Phone

(667) 367-8357

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1013757525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BUSINESS PKWY S STE 1",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211573048",
            "telephone_number": "443-839-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 LINGLESTOWN RD STE 402B",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171128508",
            "telephone_number": "667-367-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION WELLNESS CENTER PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "667-367-8357"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.