| Maryland Wellness And Recovery, Llc | |
|
11125 Rockville Pike Ste 306 Rockville MD 20852-3142 | |
| (240) 242-4225 | |
| Not Available |
| Full Name | Maryland Wellness And Recovery, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11125 Rockville Pike Ste 306, Rockville, Maryland |
| Authorized Official Name and Position | Jessie Costley (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4438396928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Wellness And Recovery, Llc 11125 Rockville Pike Ste 302 Rockville MD 20852-3142 Ph: (240) 242-4225 | Maryland Wellness And Recovery, Llc 11125 Rockville Pike Ste 306 Rockville MD 20852-3142 Ph: (240) 242-4225 |
| NPI Number | 1922862044 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Medicare PECOS PAC ID | 8022456441 |
|---|---|
| Medicare Enrollment ID | O20241025001324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922862044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amie S Kotz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699013912 PECOS PAC ID: 9335672690 Enrollment ID: I20241119002566 |
| Provider Name | Anntana Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013672997 PECOS PAC ID: 5890138804 Enrollment ID: I20241122000363 |
| Provider Name | Zachari Leazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639897994 PECOS PAC ID: 9335512136 Enrollment ID: I20241122000565 |
| Provider Name | Loretta Collins Begg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295365567 PECOS PAC ID: 3476089038 Enrollment ID: I20241206001044 |
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