| Waypoint Wellness Center, Llc | |
|
166 Defense Hwy Ste 203 Annapolis MD 21401-8922 | |
| (410) 684-3806 | |
| Not Available |
| Full Name | Waypoint Wellness Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 166 Defense Hwy Ste 203, Annapolis, Maryland |
| Authorized Official Name and Position | Allyson K Wagnaer (CO-OWNER) |
| Authorized Official Contact | 4106843806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waypoint Wellness Center, Llc 877 Baltimore Annapolis Blvd Ste 203 Severna Park MD 21146-4716 Ph: (410) 684-3806 | Waypoint Wellness Center, Llc 166 Defense Hwy Ste 203 Annapolis MD 21401-8922 Ph: (410) 684-3806 |
| NPI Number | 1437548237 |
|---|---|
| Provider Enumeration Date | 01/16/2015 |
| Last Update Date | 05/05/2023 |
| Certification Date | 05/05/2023 |
| Medicare PECOS PAC ID | 2668855560 |
|---|---|
| Medicare Enrollment ID | O20220810000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437548237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 04890 (Maryland) | Secondary |
| 103T00000X | Psychologist | 04712 (Maryland) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Raymond D Mosko |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609858125 PECOS PAC ID: 1052397080 Enrollment ID: I20040629000613 |
| Provider Name | Thomas R Sixbey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205987088 PECOS PAC ID: 9830163773 Enrollment ID: I20040825000653 |
| Provider Name | Akira Otani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811150485 PECOS PAC ID: 0244398444 Enrollment ID: I20081016000237 |
| Provider Name | Suzanne C Linkroum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720381932 PECOS PAC ID: 8527245513 Enrollment ID: I20110531000097 |
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