| Holistic Telepsych & Med Mgt. Llc | |
|
8306 Larchwood St New Carrollton MD 20784-3409 | |
| (301) 741-2232 | |
| Not Available |
| Full Name | Holistic Telepsych & Med Mgt. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8306 Larchwood St, New Carrollton, Maryland |
| Authorized Official Name and Position | Lewis Christopher Wilson (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 3017412232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Telepsych & Med Mgt. Llc 8306 Larchwood St New Carrollton MD 20784-3409 Ph: (301) 741-2232 | Holistic Telepsych & Med Mgt. Llc 8306 Larchwood St New Carrollton MD 20784-3409 Ph: (301) 741-2232 |
| NPI Number | 1811689599 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 05/22/2023 |
| Certification Date | 05/19/2023 |
| Medicare PECOS PAC ID | 2466893086 |
|---|---|
| Medicare Enrollment ID | O20240514003331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811689599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lewis C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134834393 PECOS PAC ID: 5092156729 Enrollment ID: I20240513003315 |
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