Integrated Wellness Haven LLC

Primary specialty

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

Legal business name

INTEGRATED WELLNESS HAVEN LLC

Practice address

1 Research CT
Rockville, MD 20850-3221

Phone

(301) 259-5359

NPI assigned

Nov 28, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Theodora Adedeji, LPC, LCPC, NCCNPI 1437717246

Title

Therapist

Phone

(301) 259-5359

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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

• Theodora Adedeji

  • Professional Counselor
  • Rockville, MD
  • NPI 1437717246

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1538935812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RESEARCH CT STE 450",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506252",
            "telephone_number": "301-259-5359",
            "fax_number": "301-246-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RESEARCH CT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503221",
            "telephone_number": "301-259-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20316 Wiley Ct",
            "address_purpose": "LOCATION",
            "city": "Laytonsville",
            "state": "MD",
            "postal_code": "208821207",
            "country_code": "US",
            "telephone_number": "301-259-5359",
            "fax_number": "301-246-6523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "ADEDEJI",
        "authorized_official_first_name": "THEODORA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "301-259-5359",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, LCPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Rockville, MD
• Providers in Rockville, 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 Nov 28, 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.