Clover Path Wellness LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

CLOVER PATH WELLNESS LLC

Practice address

754 N Hickory Ave Ste B
Bel Air, MD 21014-3042

Phone

(410) 286-1258

Fax

(443) 231-3684

NPI assigned

Apr 25, 2024

Last updated

Apr 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lera Ison, CRNPNPI 1952787400

Title

Administrator

Phone

(817) 319-6878

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Lera Salvatierra Ison, CRNP- F

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1952787400
  NPD Authorized official
• Anna Cresta Ibanez Decena-Trinidad, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
  • NPI 1780487504
  NPD

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1891541454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 N HICKORY AVE STE B",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143042",
            "telephone_number": "410-286-1258",
            "fax_number": "443-231-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 N HICKORY AVE STE B",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143042",
            "telephone_number": "410-286-1258",
            "fax_number": "443-231-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER PATH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "ISON",
        "authorized_official_first_name": "LERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-319-6878",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clearway Surgery Center of Bel Air LLC
• Mary Jane Cleaves-Duncan, D.C.
• Callan Cloonan, SLP/CF
• Christine B Cloonan, MA CCCA
• Mark V Clough, M.D.
• Rashawd Clowney
• Megan Jennifer Cobb, MD, DPT
• Kimberly Coby, CFNP
• Stephen M Cockey, D.D.S.
• Cohen & Norton P a

• Substance Abuse Rehabilitation Facility in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Substance Abuse Rehabilitation Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.