| Mahogany Wellness Center Llc | |
|
8777 Piney Orchard Pkwy # B172 Odenton MD 21113-2382 | |
| (443) 599-9401 | |
| Not Available |
| Full Name | Mahogany Wellness Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8777 Piney Orchard Pkwy # B172, Odenton, Maryland |
| Authorized Official Name and Position | Alicia Joseph Baker (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4435999401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahogany Wellness Center Llc 8777 Piney Orchard Pkwy # B172 Odenton MD 21113-2382 Ph: (443) 599-9401 | Mahogany Wellness Center Llc 8777 Piney Orchard Pkwy # B172 Odenton MD 21113-2382 Ph: (443) 599-9401 |
| NPI Number | 1093408452 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 05/31/2023 |
| Certification Date | 05/31/2023 |
| Medicare PECOS PAC ID | 2466816822 |
|---|---|
| Medicare Enrollment ID | O20230919000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093408452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alicia Loretta Joseph Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114151438 PECOS PAC ID: 2860669827 Enrollment ID: I20220819000570 |
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