Eselle Mathias Molua, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R215684 Issued in MD

Practice address

1447 York Rd Ste 506
Lutherville, MD 21093-6022

Phone

(410) 825-2281

NPI assigned

Aug 15, 2019

Last updated

Dec 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Complete Wellness Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor Mill, MD
  • NPI 1104590785
  Authorized official Same address or phone

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1700432689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 SANDOWN CIR APT 303",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212447928",
            "telephone_number": "240-643-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 YORK RD STE 506",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936022",
            "telephone_number": "410-825-2281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6475 New Hampshire Ave Ste 410",
            "address_purpose": "LOCATION",
            "city": "Hyattsville",
            "state": "MD",
            "postal_code": "207833276",
            "country_code": "US",
            "telephone_number": "240-643-5232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3939 Reisterstown Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212157601",
            "country_code": "US",
            "telephone_number": "410-367-7821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLUA",
        "first_name": "ESELLE",
        "middle_name": "MATHIAS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R215684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ilene Mirkin, MS, CNS, LDN LCPC
• William John Mislowsky, DDS
• Mohs and Skin Surgery Center, LLC
• John David Mojzisek, PHD, LCPC
• Susan Molinaro, M.D.
• Yehuda Aryeh Mond, M.D.
• Gretchen M. Montcalmo, CCC-SLP
• Ada Catherine Montessoro, CRNP
• John Russell Moore, M.D.
• Virginia Anne Moratz, OTR

• Psychiatric/Mental Health Nurse Practitioner in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.