Restoration of Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESTORATION OF WELLNESS

Practice address

4709 Harford Rd Ste 80
Baltimore, MD 21214-3261

Phone

(443) 906-3884

NPI assigned

Oct 29, 2020

Organization subpart

No

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

Authorized official

Name

Tasha Williams, LCSW-CNPI 1972103752

Title

Ceo

Phone

(443) 703-8582

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 4

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

• Tasha Williams, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1972103752

  Clinical, MD

  Medicare reassignment Care Compare group NPD Authorized official
• Keiryan Ashleigh Bolling, LCSW-C

  • Social Worker
  • Elkridge, MD
  • NPI 1629427307

  MD

  Medicare reassignment Care Compare group NPD
• Jessica Williams

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1770395535

  Clinical, MD

  Medicare reassignment NPD
• Naffie Jaiteh

  • Social Worker
  • Baltimore, MD
  • NPI 1265381511
  NPD (past)

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1487254272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 WOODRING AVE",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212347828",
            "telephone_number": "443-703-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 HARFORD RD STE 80",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212143261",
            "telephone_number": "443-906-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION OF WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-703-8582",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "654192500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jude Philip Restivo, D.D.S.
• Restoration Behavioral Health Systems,LLC
• Restoration Behavioral Health Systems,LLC
• Restoration Behavioral Health Systems,LLC
• Restoration Behavioral Health Systems,LLC
• Restorative Tea Therapy and Wellness Counseling LLC
• Restorative Treatment Services
• Restorative Treatment Services
• Restore You Counseling and Consultation, LLC
• Restore You Counseling and Consultation, LLC

• All providers in Baltimore, MD
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.