Organization Active NPI

Awaken the Spirit LLC

  • Clinical Social Worker
  • Catonsville, MD
National Provider Identifier
1124492665
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09177 Issued in MD
Legal business name
AWAKEN THE SPIRIT LLC
Practice address
9 Newburg Ave Ste 100
Catonsville, MD 21228-5168
Phone
(410) 747-9743
Fax
(410) 747-9910
NPI assigned
Nov 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Cheryl A DepetroNPI 1023191418
Title
Managing Director
Phone
(410) 747-9743

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 09177 MD Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X U01507 MD

Addresses

Primary practice location

9 Newburg Ave Ste 100
Catonsville, MD 21228-5168

Mailing address

9 Newburg Ave Ste 100
Catonsville, MD 21228-5168
Phone (410) 747-9743

Other identifiers 2

IdentifierTypeStateIssuer
149702200MedicaidMD
929ROtherMDMEDICARE

Other names 1

  • Awaken The Spirit Wellness Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sheridep@verizon.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160223000473 MD Part B Supplier - Clinic/Group Practice 1951606318 Receives reassigned benefits from 2 practitioners
Practice locations: Catonsville, MD

National Provider Directory

National Provider Directory

Locations

9 Newburg Ave
Ste 100
Catonsville, MD 21228
Phone (410) 747-9743

606 Edmondson Ave
Ste 201
Catonsville, MD 21228
Phone (410) 215-3602

Practitioners & affiliated clinicians

Practitioners 2

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": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1124492665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NEWBURG AVE STE 100",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285168",
            "telephone_number": "410-747-9743",
            "fax_number": "410-747-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NEWBURG AVE STE 100",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285168",
            "telephone_number": "410-747-9743",
            "fax_number": "410-747-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN THE SPIRIT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2025-09-02",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "DEPETRO",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "410-747-9743"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09177",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U01507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149702200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "929R",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sheridep@verizon.net",
            "affiliation": "N",
            "endpointDescription": "Practice email",
            "address_1": "9 Newburg Ave Ste 100",
            "city": "Catonsville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212285168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Awaken The Spirit Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.