Etw Therapeutic & Holistic Services LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

ETW THERAPEUTIC & HOLISTIC SERVICES LLC

Practice address

7305 Baltimore Ave Ste A101
College Park, MD 20740-3234

Phone

(410) 824-1480

Fax

(410) 824-1482

NPI assigned

Sep 13, 2022

Organization subpart

No

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

Authorized official

Name

Priyanka Malhotra

Title

Credentialing Director

Phone

(013) 771-8363

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Tax ID family

Etw Therapeutic Holistic Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Etw Therapeutic & Holistic Services LLC

  • Rehabilitation Clinic/Center
  • College Park, MD
  • NPI 1053033126
  NPD tax ID

Practitioners 1

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

• Eric Whitaker, PHD, LCSW-C, LICSW

  • Clinical Social Worker
  • Ft Washington, MD
  • NPI 1225436231
  NPD

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1083336580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 SHOCKLEY CT",
            "city": "FT WASHINGTON",
            "state": "MD",
            "postal_code": "207441711",
            "telephone_number": "410-824-1480",
            "fax_number": "410-824-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 BALTIMORE AVE STE A101",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207403234",
            "telephone_number": "410-824-1480",
            "fax_number": "410-824-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETW THERAPEUTIC & HOLISTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "PRIYANKA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "013-771-8363"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555991000",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "companyemail",
            "affiliation": "N",
            "endpointDescription": "companyemail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIPAA",
            "address_1": "10903 Indian Head Hwy Ste 404",
            "city": "Ft Washington",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207444019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "companyemail",
            "affiliation": "N",
            "endpointDescription": "companyemail",
            "address_1": "7305 Baltimore Ave Ste A101",
            "city": "College Park",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207403234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott A Ellis, MS, ATC
• Helina Airoboma Esene, NP
• Cecile Eleh Edie Etoke
• Olatunde Etti-Williams
• Etw Therapeutic & Holistic Services LLC
• Etw Therapeutic & Holistic Services LLC
• Lisa Marie Euliss, RD, LDN
• Evolve Therapy & Wellness LLC
• Expert Smiles, Inc
• Express Healthcare, LLC

• Adult Mental Health Clinic/Center in College Park, MD
• Providers in College Park, MD by specialty
• Adult Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.