NPIMap

Organization Active NPI

Selah Wellness & Therapeutic Services, LLC

  • Clinical Social Worker
  • Largo, MD
National Provider Identifier
1952900540
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SELAH WELLNESS & THERAPEUTIC SERVICES, LLC
Practice address
1401 Mercantile LN Ste 485
Largo, MD 20774-4301
Phone
(301) 875-5680
Fax
(240) 266-0557
NPI assigned
Oct 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Mrs. Sharon Jennings Lawrence, LCSW-CNPI 1144453713
Title
Owner/Therapist
Phone
(301) 875-5680

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 Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1401 Mercantile LN Ste 485
Largo, MD 20774-4301

Mailing address

1401 Mercantile LN Ste 485
Largo, MD 20774-4301
Phone (301) 875-5680

Other practice location 1

7320 E Fletcher Ave
Tampa, FL 33637-0916
Phone (301) 875-5680

National Provider Directory

National Provider Directory
Tax ID family
Selah Wellness Therapeutic Services 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1952900540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 485",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-875-5680",
            "fax_number": "240-266-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 485",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-875-5680",
            "fax_number": "240-266-0557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7320 E Fletcher Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336370916",
            "country_code": "US",
            "telephone_number": "301-875-5680",
            "fax_number": "240-266-0557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SELAH WELLNESS & THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "JENNINGS",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "301-875-5680",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.