Wellbrook Behavioral Health Services

Primary specialty

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

Legal business name

WELLBROOK BEHAVIORAL HEALTH SERVICES

Practice address

5764 Stevens Forest Rd Apt 322
Columbia, MD 21045-3758

Phone

(410) 935-5177

Fax

(410) 695-3778

NPI assigned

Jun 2, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Waibogha, LCSW-CNPI 1245567536

Title

Ceo

Phone

(304) 322-0275

Specialties & licenses 3

Addresses

Electronic endpoints 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly F Waibogha, LICSW

  • Clinical Social Worker
  • Morgantown, WV
  • NPI 1245567536
  NPD (past) Authorized official

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1487220281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 STEVENS FOREST RD APT 322",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453758",
            "telephone_number": "410-935-5177",
            "fax_number": "410-695-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 STEVENS FOREST RD APT 322",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453758",
            "telephone_number": "410-935-5177",
            "fax_number": "410-695-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBROOK BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-04-04",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "WAIBOGHA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-322-0275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drkimberly@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5764 Stevens Forest Rd Apt 322",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210453758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberlyw@wellbrookbehavioralhealthservices.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5764 Stevens Forest Rd Apt 322",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210453758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Leigh Welch, R.N.
• Benorayehush Weldetsadik, M.D.
• Jessica Weldon, MA, CCC-SLP
• Laura Kristen Welker-Hood, SCD, MSN RN
• Wellbeing Designed, LLC
• Welldoc, Inc.
• Danielle Weller-Roche, RN
• Naomi J Weller, LCSW-C
• Wellness Restoration Counseling PLLC
• Wellness Space Counseling and Consulting, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Columbia, MD
• Providers in Columbia, 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 Apr 4, 2023; 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.