Ethereal Wellness Clinic LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

ETHEREAL WELLNESS CLINIC LLC

Practice address

1645 Liberty Rd Ste 102
Sykesville, MD 21784-6537

Phone

(443) 398-7018

NPI assigned

Nov 4, 2025

Last updated

Nov 4, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yani MaoNPI 1265301477

Title

Owner

Phone

(443) 398-7018

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Yani Mao

  • Acupuncturist
  • Gaithersburg, MD
  • NPI 1265301477
  NPD Authorized official

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1215806427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LIBERTY RD STE 102",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846537",
            "telephone_number": "443-398-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LIBERTY RD STE 102",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846537",
            "telephone_number": "443-398-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEREAL WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "MAO",
        "authorized_official_first_name": "YANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-398-7018"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eldersburg Pediatric Dentistry, LLC (Tiny Tooth Pediatric Dentistry)
• Sara Eliason-Cappella, PSYD
• Hollie Burdt Ellis, DDS
• Ema Health Services
• Grace Erb, ADT, LMSW
• Tyler Evans
• Evercare Living LLC
• Alayna Marie Facchina, RD, LDN
• Family Strength LLC
• Cristina Fernandez, INTERPRETER

• Acupuncturist in Sykesville, MD
• Providers in Sykesville, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.