Maryland Wellness Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARYLAND WELLNESS PSYCHOTHERAPY, LLC

Practice address

110 N Washington St Ste 200-15
Rockville, MD 20850-2223

Phone

(301) 661-1375

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Daniel P Macy

Title

Managing Member

Phone

(301) 661-1375

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CRM Therapy, LLC Former legal business name

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.

• Constance Rojas Macy

  • Clinical Social Worker
  • Gaithersburg, MD
  • NPI 1407021777

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1295585214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 BRYN MAWR AVE",
            "city": "GLEN ECHO",
            "state": "MD",
            "postal_code": "208121101",
            "telephone_number": "301-661-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N WASHINGTON ST STE 200-15",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208502223",
            "telephone_number": "301-661-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND WELLNESS PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "301-661-1375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407021777",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRM Therapy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CRM Therapy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Maryland Treatment Centers, Inc.
• Maryland Urogynecology, LLP
• Maryland Wellness and Recovery LLC
• Maryland Wellness and Recovery, LLC
• Maryland Wellness Center LLC
• Ronnicia Maryland
• Abubakr A Marzouk, M.D.
• Hilda Masama
• Kush Mashruwala
• Saba Masih

• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.