Maternal Wellness Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MATERNAL WELLNESS CENTER LLC

Doing business as

Maternal Wellness Center

Practice address

67 Byberry Rd
Hatboro, PA 19040-3205

Phone

(215) 649-9916

NPI assigned

Aug 7, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kellie L. Wicklund, MA, LPC, PHM-CNPI 1932534633

Title

Owner / Director

Phone

(267) 432-2374

Specialties & licenses 1

Addresses

Other names 1

• Maternal Wellness Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie Lynn Wicklund, MA, NCP, LPC

  • Mental Health Counselor
  • Abington, PA
  • NPI 1932534633
  NPD Authorized official

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1861002461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 W WASHINGTON LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442602",
            "telephone_number": "267-432-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BYBERRY RD",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190403205",
            "telephone_number": "215-649-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "WICKLUND",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER / DIRECTOR",
        "authorized_official_telephone_number": "267-432-2374",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LPC, PHM-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maternal Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tania J Malara, O.D.
• Erica Marinelli, CRNP
• Allison Rose Martin
• Patricia Martin
• Maria Patricia Martinez Lehmann, M.D.
• Jessica Rose Matthews, MPT
• Sharyvette Mattos, LCSW
• Cornelia Martha McBride, MS
• Kerry McCarron
• Monica Marie McCarthy, PTA

• Adult Mental Health Clinic/Center in Hatboro, PA
• Providers in Hatboro, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.