Milestone Wellness LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MILESTONE WELLNESS LLC

Practice address

370A Main St
Laurel, MD 20707-4133

Phone

(240) 755-1056

NPI assigned

Nov 30, 2020

Organization subpart

No

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

Authorized official

Name

Deborah G Adedeji, PMHNPNPI 1811183973

Title

President

Phone

(240) 755-1056

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deborah Gbemisola Adedeji, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksburg, MD
  • NPI 1811183973

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1255936217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12817 FOX FERN LN",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714040",
            "telephone_number": "240-755-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370A MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074133",
            "telephone_number": "240-755-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12817 Fox Fern Ln",
            "address_purpose": "LOCATION",
            "city": "Clarksburg",
            "state": "MD",
            "postal_code": "208714040",
            "country_code": "US",
            "telephone_number": "240-755-1056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MILESTONE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "ADEDEJI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-755-1056",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Mickey
• Mid-Atlantic Medical
• Midatlantic Sleep Disorder Center LLC
• Miles of Smiles Dental Associates
• Maurice Sebastian Miles, D.D.S
• Nicholas Miller
• Nicole Miller, OT
• Rachel Ann Miller, PT, DPT
• Nancy Mills, R.N., C.P.N.P.
• Jeen Min

• Mental Health Clinic/Center (Including Community Mental Health Center) in Laurel, MD
• Providers in Laurel, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.