NPIMap

Organization Active NPI

Premier Wellness Healthcare

  • Clinical Psychologist
  • Forest Hill, MD
National Provider Identifier
1376087635
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PREMIER WELLNESS HEALTHCARE
Practice address
2209 Commerce Rd Ste 1
Forest Hill, MD 21050-2539
Phone
(888) 333-1345
Fax
(410) 734-2025
NPI assigned
Dec 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Cynthia Dicara
Title
Owner
Phone
(888) 333-1345

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2209 Commerce Rd Ste 1
Forest Hill, MD 21050-2539

Mailing address

133 Black Oak TRL
Delta, PA 17314-8756

Other practice location 1

103 N Main St
Bel Air, MD 21014-3539
Phone (888) 333-1345

Other identifiers 1

IdentifierTypeStateIssuer
7635036-00MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Premier Wellness Healthcare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

103 N Main St
#A
Bel Air, MD 21014
Phone (888) 333-1345

4 E Jarrettsville Rd
Ste G
Forest Hill, MD 21050
Phone (888) 333-1345

2209 Commerce Rd
Ste 1
Forest Hill, MD 21050

Practitioners & affiliated clinicians

Practitioners 8

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": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1376087635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BLACK OAK TRL",
            "city": "DELTA",
            "state": "PA",
            "postal_code": "173148756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 COMMERCE RD STE 1",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502539",
            "telephone_number": "888-333-1345",
            "fax_number": "410-734-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 N Main St",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210143539",
            "country_code": "US",
            "telephone_number": "888-333-1345",
            "fax_number": "888-653-0154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER WELLNESS HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "DICARA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-333-1345"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7635036-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.