NPIMap

Organization Active NPI

For Wellness, LLC

  • Clinical Social Worker
  • Laurel, MD
National Provider Identifier
1053049544
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FOR WELLNESS, LLC
Practice address
10003 Ruffian Way Unit B
Laurel, MD 20723-2088
Phone
(240) 706-0748
NPI assigned
Aug 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Jasmine Tierra Lache White, LCSW-CNPI 1245898014
Title
Psychotherapist / Owner
Phone
(240) 706-0748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

10003 Ruffian Way Unit B
Laurel, MD 20723-2088

Mailing address

10003 Ruffian Way Unit B
Laurel, MD 20723-2088
Phone (240) 706-0748

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL forwellnessllc@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1053049544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 RUFFIAN WAY UNIT B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232088",
            "telephone_number": "240-706-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 RUFFIAN WAY UNIT B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232088",
            "telephone_number": "240-706-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOR WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JASMINE TIERRA",
        "authorized_official_middle_name": "LACHE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST / OWNER",
        "authorized_official_telephone_number": "240-706-0748",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "forwellnessllc@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10003 Ruffian Way Unit B",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207232088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.