NPIMap

Organization Active NPI

Wholistic Living, LLC

  • Mental Health Counselor
  • Bel Air, MD
National Provider Identifier
1891198925
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13592 Issued in MD
Legal business name
WHOLISTIC LIVING, LLC
Practice address
1035 Emmorton Road
Bel Air, MD 21014
Phone
(410) 937-1386
NPI assigned
Oct 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Authorized official

Name
Shelby J JohnNPI 1881882165
Title
Director
Phone
(410) 937-1386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 13592 MD Primary

Addresses

Primary practice location

1035 Emmorton Road
Bel Air, MD 21014

Mailing address

2410 Chatau CT
Fallston, MD 21047-2318
Phone (410) 937-1386

Other identifiers 1

IdentifierTypeStateIssuer
414765100MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150929000127 MD Part B Supplier - Clinic/Group Practice 2365750189 Receives reassigned benefits from 2 practitioners
Practice locations: Fallston, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1891198925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 CHATAU CT",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210472318",
            "telephone_number": "410-937-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 EMMORTON ROAD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21014",
            "telephone_number": "410-937-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTIC LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-937-1386"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "13592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414765100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.