NPIMap

Organization Active NPI

Holistic Wellness Services

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
National Provider Identifier
1609587120
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
HOLISTIC WELLNESS SERVICES
Practice address
3806 Ravenwood Ave
Baltimore, MD 21213-2022
Phone
(443) 629-0646
NPI assigned
Dec 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Vickie Cooke, LCADCNPI 1306203880
Title
Ceo / Founder
Phone
(443) 629-0646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

3806 Ravenwood Ave
Baltimore, MD 21213-2022

Mailing address

PO Box 3394
Baltimore, MD 21213-0394
Phone (443) 629-0646

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1609587120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3394",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212130394",
            "telephone_number": "443-629-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 RAVENWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132022",
            "telephone_number": "443-629-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "CEO / FOUNDER",
        "authorized_official_telephone_number": "443-629-0646",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.