Cervello-Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CERVELLO-WELLNESS, LLC

Practice address

6010 Executive Blvd Ste 700
Rockville, MD 20852-3885

Phone

(301) 392-7120

NPI assigned

Apr 3, 2025

Organization subpart

No

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

Authorized official

Name

Mimi Tyson, NPNPI 1952960924

Title

Owner

Phone

(301) 828-5239

Specialties & licenses 1

Addresses

Tax ID family

Cervello-Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cervello-Wellness, LLC

  • Community/Behavioral Health Agency
  • North Bethesda, MD
  • NPI 1619856887
  NPD tax ID

Practitioners 1

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

• Mimi Tyson

  • Psychiatric/Mental Health Nurse Practitioner
  • North Bethesda, MD
  • NPI 1952960924
  NPD (past) Authorized official

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1942004262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 DIAMONDHEAD AVE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211308",
            "telephone_number": "301-828-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 EXECUTIVE BLVD STE 700",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523885",
            "telephone_number": "301-392-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERVELLO-WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "MIMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-828-5239",
        "authorized_official_credential": "NP"
    },
    "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": []
}

• Oscar Cerrito Mendoza
• Fiorella Cerro
• Certified Ambulatory Surgery Center
• Estrella Cervantes-Lopez
• Giselle Cervantes
• Marc Daniel Cesari, D.C.
• Michael G Cetta, MD
• Neobe Mariana Ceu
• Alisson Cevallos Moreira
• CH Specialty Services MD LLC

• All providers in Rockville, MD
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.