NPIMap

Organization Active NPI

Well Life Counseling and Consulting, LLC

  • Clinical Psychologist
  • Nottingham, MD
National Provider Identifier
1891190054
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04581 Issued in MD
Legal business name
WELL LIFE COUNSELING AND CONSULTING, LLC
Practice address
9649 Belair Rd Ste 104
Nottingham, MD 21236-1117
Phone
(410) 529-1309
Fax
(410) 529-1005
NPI assigned
Oct 30, 2014
Last updated
Jun 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Authorized official

Name
Dr. Julie Ann Beasman, PSYDNPI 1558593988
Title
Psychologist
Phone
(410) 529-1309

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 PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 04581 MD Primary

Addresses

Primary practice location

9649 Belair Rd Ste 104
Nottingham, MD 21236-1117

Mailing address

9649 Belair Rd Ste 104
Nottingham, MD 21236-1117
Phone (410) 921-9078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150102000734 MD Part B Supplier - Clinic/Group Practice 0446573166 Receives reassigned benefits from 14 practitioners
Practice locations: Nottingham, MD

National Provider Directory

National Provider Directory

Locations

9309 Belair Rd
Ste A
Nottingham, MD 21236
Phone (410) 529-1309

9649 Belair Rd
Ste 104
Nottingham, MD 21236
Phone (410) 529-1309

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686960000000",
    "number": "1891190054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9649 BELAIR RD STE 104",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361117",
            "telephone_number": "410-921-9078",
            "fax_number": "410-529-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9649 BELAIR RD STE 104",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361117",
            "telephone_number": "410-529-1309",
            "fax_number": "410-529-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL LIFE COUNSELING AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-17",
        "status": "A",
        "authorized_official_last_name": "BEASMAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "410-529-1309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.