NPIMap

Organization Active NPI

Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lanham, MD
National Provider Identifier
1659520476
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MARYLAND WELLNESS LLC
Practice address
4200 Forbes Blvd
Suite104
Lanham, MD 20706-4342
Phone
(301) 429-6100
Fax
(301) 429-1333
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Casey Wu
Title
Director of Special Projects
Phone
(410) 241-6317

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4200 Forbes Blvd
Suite104
Lanham, MD 20706-4342

Mailing address

4128 Hayward Ave
Baltimore, MD 21215-4340
Phone (410) 241-6317

Other identifiers 5

IdentifierTypeStateIssuer
220412507OtherMDMARYLAND BEHAVIORAL HEALTH ADMINISTRATION
200710000OtherMDMARYLAND BEHAVIORAL HEALTH ADMINISTRATION
220412453OtherMDMARYLAND BEHAVIORAL HEALTH ADMINISTRATION
200710001OtherMDMARYLAND BEHAVIORAL HEALTH ADMINISTRATION
200710002OtherMDMARYLAND BEHAVIORAL HEALTH ADMINISTRATION

National Provider Directory

National Provider Directory
Tax ID family
Alek'S House LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1659520476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 HAYWARD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154340",
            "telephone_number": "410-241-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 FORBES BLVD",
            "address_2": "SUITE104",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064342",
            "telephone_number": "301-429-6100",
            "fax_number": "301-429-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "DIRECTOR OF SPECIAL PROJECTS",
        "authorized_official_telephone_number": "410-241-6317"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BEHAVIORAL HEALTH ADMINISTRATION",
            "identifier": "220412507",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BEHAVIORAL HEALTH ADMINISTRATION",
            "identifier": "200710000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BEHAVIORAL HEALTH ADMINISTRATION",
            "identifier": "220412453",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BEHAVIORAL HEALTH ADMINISTRATION",
            "identifier": "200710001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BEHAVIORAL HEALTH ADMINISTRATION",
            "identifier": "200710002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.