NPIMap

Organization Active NPI

Sacred Path Wellness

  • Clinical Social Worker
  • Bowie, MD
National Provider Identifier
1154936185
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SACRED PATH WELLNESS
Practice address
2905 Mitchellville Rd Ste 112
Bowie, MD 20716-1321
Phone
(240) 394-1363
NPI assigned
Sep 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Authorized official

Name
Genni Harrison, LCSW-CNPI 1659688539
Title
Executive Director
Phone
(240) 394-1363

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

2905 Mitchellville Rd Ste 112
Bowie, MD 20716-1321

Mailing address

13017 Rhapsody LN
Silver Spring, MD 20904-6864

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": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1154936185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13017 RHAPSODY LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209046864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD STE 112",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161321",
            "telephone_number": "240-394-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED PATH WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "GENNI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-394-1363",
        "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": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.