Organization Active NPI

Elite Self Development

  • Community/Behavioral Health Agency
  • Waldorf, MD
National Provider Identifier
1467387811
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ELITE SELF DEVELOPMENT
Practice address
3680 Leonardtown Rd Ste 201
Waldorf, MD 20601-3697
Phone
(443) 850-2142
NPI assigned
Jun 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Authorized official

Name
Gwenae Carter
Title
Ceo
Phone
(410) 846-2008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3680 Leonardtown Rd Ste 201
Waldorf, MD 20601-3697

Mailing address

9707 Bird River Rd
Middle River, MD 21220-1701
Phone (443) 850-2142

National Provider Directory

National Provider Directory
Tax ID family
Elite Self Development2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3680 Leonardtown Rd
Ste 201
Waldorf, MD 20601

NPI Registry JSON

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

{
    "created_epoch": "1781568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1467387811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9707 BIRD RIVER RD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201701",
            "telephone_number": "443-850-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 LEONARDTOWN RD STE 201",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013697",
            "telephone_number": "443-850-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SELF DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-16",
        "last_updated": "2026-06-16",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "GWENAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-846-2008"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.