NPIMap

Organization Active NPI

Wimberley Wellness, LLC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1720722986
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WIMBERLEY WELLNESS, LLC
Practice address
3500 Boston St Ste 421
Baltimore, MD 21224-5281
Phone
(410) 907-7656
Fax
(410) 457-3205
NPI assigned
Apr 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Vaughan R Wimberley, LCSW-CNPI 1275025926
Title
Owner, Therapist
Phone
(443) 374-8686

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3500 Boston St Ste 421
Baltimore, MD 21224-5281

Mailing address

3500 Boston St Ste 421
Baltimore, MD 21224-5281
Phone (443) 374-8686

Other practice location 1

820 S Macon St
Baltimore, MD 21224-4439
Phone (443) 374-8686

National Provider Directory

National Provider Directory

Locations

3500 Boston St
Ste 421
Baltimore, MD 21224
Phone (410) 907-7656

Practitioners & affiliated clinicians

Practitioners 7

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": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1720722986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST STE 421",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245281",
            "telephone_number": "443-374-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST STE 421",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245281",
            "telephone_number": "410-907-7656",
            "fax_number": "410-457-3205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 S Macon St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212244439",
            "country_code": "US",
            "telephone_number": "443-374-8686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WIMBERLEY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "WIMBERLEY",
        "authorized_official_first_name": "VAUGHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "443-374-8686",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "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 Apr 28, 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.