BLUE SPRING WELLNESS CENTER LLC
BLUE SPRING WELLNESS CENTER LLC · Nurse Practitioner (Psych/Mental Health)

Address: 807 East Baltimore St, Unit 1a, Baltimore, MD 21202-5388

BLUE SPRING WELLNESS CENTER LLC (NPI# 1497349997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497349997
Entity Type Organization
Organization Name BLUE SPRING WELLNESS CENTER LLC
Other Organization Name BLUE SPRING WELLNESS CENTER LLC (Doing Business As Name)
Practice Address 807 East Baltimore St, Unit 1a
Baltimore
MD 21202-5388
Practice Telephone 4104565812
Mailing Address 8 Hallsdale Ct
Rosedale
MD 21237-5009
Mailing Telephone 4104565812
Certification Date 2021-03-03
Enumeration Date 2021-02-24
Last Update Date 2021-03-03
Authorized Official Telephone 4104565812
Authorized Official Credential CRNP-PMH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
193400000X SINGLE SPECIALTY GROUP Physician Assistants & Advanced Practice Nursing Providers
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Blue Spring Wellness Center LLC Doing Business As Name

Office Location

Street Address 807 EAST BALTIMORE ST, UNIT 1A,
City BALTIMORE
State MD
Zip Code 21202-5388

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1184201295 Samara Elise Pollock Student in an Organized Health Care Education/Training Program 345 St. Paul Place, Bunting Bldg, 7th Fl, Baltimore, MD 21202 2021-03-25
1144816786 Jennifer Sequera Pharmacist · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Mercy Medical Center Anticoagulation Clinic, 301 St. Paul Place, Baltimore, MD 21202 2020-12-17
1750938650 Anthony Graves Behavior Technician 414 Light Street, Baltimore, MD 21202 2019-08-25
1235786609 Perfected Medical Billing & Consulting Service Inc. Rehabilitation Counselor 11 E Mt Royal Avenue, 3rd Flr Ste 2, Baltimore, MD 21202 2019-08-21
1700430246 Ronie George Nurse Practitioner · Neonatal 345 St. Paul Place Dept of Pediatrics, Baltimore, MD 21202 2019-08-01
1043879315 Myrna C. Jackson Social Worker · Clinical 200 E. North Ave, Related Services Rm 210, Baltimore, MD 21202 2019-06-11
1720647175 Ivelysse Claudio Cortes Speech-Language Pathologist Rsu/Ofic of Spec Educ- Speech-Language Department, 200 E North Avenue, Room 211, Baltimore, MD 21202 2019-06-10
1750940185 Katherine Wachter Mullins Social Worker · Clinical 200 East North Ave, Related Services - Rm 210, Baltimore, MD 21202 2019-06-10
1497314157 Debera Marie Reznitsky Speech-Language Pathologist 200 East North Avenue, Related Services Rm 210, Baltimore, MD 21202 2019-06-06
1154989952 Zirka Oksanna Hanas Speech-Language Pathologist 200 E. North Avenue, Related Services Room #210, Baltimore, MD 21202 2019-06-05
Find all providers in zip 21202

Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1760060636 Walter Lewis Toller IIi 2439 E Lafayette Ave, Baltimore, MD 21213-2562 2021-03-31
1578141602 Candace Womack 2727 W Garrison Ave, Baltimore, MD 21215-5332 2021-03-30
1487249025 Olayemi Tosin Ayilegbe 400 E Patapsco Ave, Baltimore, MD 21225-1830 2021-03-05
1497347660 Mary Ranti Alabi 3001 S Hanover Street, Baltimore, Md 21225, Baltimore, MD 21225-2122 2021-02-09
1083210447 Ashlee Joyce Crawford 2 E Wells St Apt 356, Baltimore, MD 21230-4945 2020-12-09
1992308696 Marshall James 601 N Eutaw St Apt 518, Baltimore, MD 21201-7410 2020-11-17
1013516590 Yohannes Berihun Tegegne 11 E Lexington St Ste 600, Baltimore, MD 21202-1711 2020-10-26
1184233595 Imani House Medical Services 6101 Park Heights Ave Apt 1d, Baltimore, MD 21215-3640 2020-07-31
1194334268 Arp Counseling & Therapeutic Services 1721 Pennsylvania Ave Ste 205, Baltimore, MD 21217-3119 2020-07-24
1023635877 Emu Godspower Ohwobete 6 Aspinwood Way Apt E, Baltimore, MD 21237-4210 2020-06-28
Find all providers in BALTIMORE

Competitor

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City BALTIMORE
Zip Code 21202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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