NPIMap

Organization Active NPI

Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hampstead, MD
National Provider Identifier
1760065643
Registry record updated Apr 16, 2025
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
4500 Black Rock Rd # G2
Hampstead, MD 21074-2636
Phone
(410) 241-6317
NPI assigned
Apr 29, 2021
Organization subpart
Yes
Parent organization
MARYLAND WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Ms. Sierra Burley
Title
Credentialing Specialist
Phone
(410) 314-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4500 Black Rock Rd # G2
Hampstead, MD 21074-2636

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Maryland Wellness LLC39 organizations share this tax ID, including this one
Part of
Maryland Wellness LLC

Other organizations with this tax ID 38

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

View all 38

Locations

4500 Black Rock Rd
#G2
Hampstead, MD 21074
Phone (410) 241-6317

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1760065643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 HAYWARD AVE # W",
            "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": "4500 BLACK ROCK RD # G2",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210742636",
            "telephone_number": "410-241-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARYLAND WELLNESS LLC",
        "enumeration_date": "2021-04-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "BURLEY",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "410-314-1030",
        "authorized_official_name_prefix": "Ms."
    },
    "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": []
}

Other providers in Hampstead, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.