NPIMap

Organization Active NPI

The Personal Wellness Center

  • Mental Health Counselor
  • Salisbury, MD
National Provider Identifier
1093050890
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11098 Issued in MD
Legal business name
THE PERSONAL WELLNESS CENTER
Practice address
6508 Deer Pointe Dr Ste 4C
Salisbury, MD 21804-1668
Phone
(410) 742-6016
Fax
(410) 742-6014
NPI assigned
Dec 5, 2012
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Veronica Correa, LCSW-CNPI 1447362744
Title
Clinical Director/Owner
Phone
(410) 742-6016

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 11098 MD Primary

Addresses

Primary practice location

6508 Deer Pointe Dr Ste 4C
Salisbury, MD 21804-1668

Mailing address

6508 Deer Pointe Dr Ste 4C
Salisbury, MD 21804-1668
Phone (410) 742-6016

Other identifiers 1

IdentifierTypeStateIssuer
890009400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130503000021 MD Part B Supplier - Clinic/Group Practice 7315184777 Receives reassigned benefits from 15 practitioners
Practice locations: Salisbury, MD

National Provider Directory

National Provider Directory
Tax ID family
Personal Wellness Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

106 Milford St
Ste 701
Salisbury, MD 21804
Phone (410) 742-3112

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1093050890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 DEER POINTE DR STE 4C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041668",
            "telephone_number": "410-742-6016",
            "fax_number": "410-742-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 DEER POINTE DR STE 4C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041668",
            "telephone_number": "410-742-6016",
            "fax_number": "410-742-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PERSONAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "410-742-6016",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "11098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890009400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.