Active NPI
Elite Self Development
- Community/Behavioral Health Agency
- Waldorf, MD
National Provider Identifier
1467387811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 Development
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Waldorf, MD
- NPI 1861323586
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.