Organization Active NPI

Elevate Mental Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reisterstown, MD
National Provider Identifier
1790679504
Registry record updated Jun 5, 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
ELEVATE MENTAL WELLNESS LLC
Practice address
25 Main St Ste D
Reisterstown, MD 21136-1297
Phone
(410) 205-5390
NPI assigned
Jun 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Mr. Marcus Whitehead
Title
Executive Director
Phone
(410) 205-5390

Specialties & licenses 1

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

Addresses

Primary practice location

25 Main St Ste D
Reisterstown, MD 21136-1297

Mailing address

PO Box 1
Woodstock, MD 21163-0001
Phone (410) 205-5390

National Provider Directory

National Provider Directory

Locations

25 Main St
Ste D
Reisterstown, MD 21136
Phone (410) 205-5390

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1790679504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211630001",
            "telephone_number": "410-205-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MAIN ST STE D",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361297",
            "telephone_number": "410-205-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-205-5390",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.