NPIMap

Organization Active NPI

Montgomery Wellness Hub LLC

  • Mental Health Counselor
  • Gaithersburg, MD
National Provider Identifier
1255118022
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MONTGOMERY WELLNESS HUB LLC
Practice address
951 Russell Ave Ste D
Gaithersburg, MD 20879-3283
Phone
(301) 404-7336
Fax
(240) 246-7911
NPI assigned
Sep 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Authorized official

Name
Mohammed Kolawole Ibrahim
Title
Ceo
Phone
(240) 246-7837

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community Health Clinic/Center 261QC1500X

Addresses

Primary practice location

951 Russell Ave Ste D
Gaithersburg, MD 20879-3283

Mailing address

951 Russell Ave Ste D
Gaithersburg, MD 20879-3283
Phone (301) 404-7336

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Wellness Hub LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1255118022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 RUSSELL AVE STE D",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793283",
            "telephone_number": "301-404-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 RUSSELL AVE STE D",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793283",
            "telephone_number": "301-404-7336",
            "fax_number": "240-246-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY WELLNESS HUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "KOLAWOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-246-7837"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.