Total Wellness Mental Health Clinic LLC

Primary specialty

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

Legal business name

TOTAL WELLNESS MENTAL HEALTH CLINIC LLC

Practice address

2504 Highcrest CT
Manchester, MD 21102-1413

Phone

(443) 895-0898

NPI assigned

Oct 31, 2023

Last updated

Oct 31, 2023By 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

Cynthia EkwutifeNPI 1194364588

Title

President

Phone

(443) 895-0898

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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.

• Cynthia Ekwutife, DNP CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Owings Mills, MD
  • NPI 1194364588
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1467225581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 HIGHCREST CT",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211021413",
            "telephone_number": "443-895-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 HIGHCREST CT",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211021413",
            "telephone_number": "443-895-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL WELLNESS MENTAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "EKWUTIFE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-895-0898"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rose L. Varela, L.G.P.C., N.C.C.
• Angella Vassell, M.ED CSC-AD
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• Bryanna Waltz
• Crystal Weise, CRNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Manchester, MD
• Providers in Manchester, 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 Oct 31, 2023; 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.