CERVELLO-WELLNESS, LLC (NPI# 1083239255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083239255 |
| Entity Type | Organization |
| Organization Name | CERVELLO-WELLNESS, LLC |
| Practice Address |
8101 Sandy Spring Rd Laurel MD 20707-3596 |
| Mailing Address |
6051 Knights Ridge Way Alexandria VA 22310-1637 |
| Practice Telephone | 3018285239 |
| Mailing Telephone | 3018285239 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Authorized Official Name | MISS MIMI TYSON (CRNP/PROVIDER) |
| Authorized Official Telephone | 3018285239 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 521090900 | 05 |
| Street Address |
8101 SANDY SPRING RD |
| City | LAUREL |
| State | MD |
| Zip Code | 20707-3596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184751604 | Colleen Denise Mitchell | Psychologist | 8101 Sandy Spring Rd, Suite 100f, Laurel, MD 20707-3596 | 2007-02-28 |
| 1174151633 | Tower Behavioral Services, LLC. | Community Health Worker | 8101 Sandy Spring Rd, Laurel, MD 20707-3596 | 2020-03-31 |
| 1629606603 | Tower Behavioral Services, LLC. | Clinic/Center | 8101 Sandy Spring Rd, Laurel, MD 20707-3596 | 2020-03-27 |
| 1942863097 | Community Health Education and Research Corporation | Rehabilitation Unit | 8101 Sandy Spring Rd, Ste 300e6, 300w31, Laurel, MD 20707-3596 | 2019-04-15 |
| 1053879304 | Procedra, LLC | In Home Supportive Care | 8101 Sandy Spring Rd, Laurel, MD 20707 | 2019-03-06 |
| 1962994673 | Anayo Chukwurah-orezabo | Social Worker | 8101 Sandy Spring Rd, Laurel, MD 20707 | 2018-05-30 |
| 1932658671 | Imara Counseling Services | Counselor | 8101 Sandy Spring Rd, 250, Laurel, MD 20707-3596 | 2016-09-22 |
| 1730547266 | Colleen D Mitchell, Phd, LLC | Psychologist | 8101 Sandy Spring Rd, Suite 100f, Laurel, MD 20707-3596 | 2016-01-28 |
| 1619332293 | Heather Norden | Psychologist | 8101 Sandy Spring Rd, Ste 100f, Laurel, MD 20707-3596 | 2015-12-23 |
| 1679972855 | Lca Psychological Associates, LLC | Counselor | 8101 Sandy Spring Rd, 100 F, Laurel, MD 20707-3596 | 2014-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157156 | Mini'imah Wilson | Social Worker | 15041 Cherrywood Dr, Laurel, MD 20707 | 2020-08-31 |
| 1548893985 | Ernest Freeman | Clinic/Center | 367 Main St., Laurel, Laurel, MD 20707 | 2020-02-13 |
| 1538701859 | Family Health and Wellness Clinic LLC | Clinic/Center | 324 Main St. #523, Laurel, MD 20707 | 2019-10-09 |
| 1467018226 | Leena Daniel | Nurse Practitioner | 13 C Street, Suite D, Laurel, MD 20707 | 2019-05-16 |
| 1538723143 | Florence Okojie | Nurse Practitioner | 13 C St Ste G, Laurel, MD 20707 | 2019-04-29 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1043709637 | Bk Behavioral Health Center | Behavior Technician | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707 | 2018-05-09 |
| 1053800839 | Bk Behaviorial Health Center | Substance Abuse Rehabilitation Facility | 14300 Cherry Lane Court, Suite 202-203, Laurel, MD 20707 | 2018-05-07 |
| 1316435795 | Laurel Pharmacy II LLC | Pharmacy | 14402 Baltimore Ave, Laurel, MD 20707 | 2018-05-01 |
| Find all providers in zip 20707 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364814 | Adedoyin Sobowale | Nurse Practitioner | 7701 Beall Rd, Laurel, MD 20707-3300 | 2020-07-31 |
| 1003437377 | Judith Tangi | Nurse Practitioner | 8125 Mallard Shore Dr, Laurel, MD 20724-2967 | 2020-04-28 |
| 1922664796 | Maryrose Otugo | Nurse Practitioner | 14301 Wilshire Ct, Laurel, MD 20707-9512 | 2019-05-16 |
| 1316404353 | Maria Neh Tancho | Nurse Practitioner | 13715 Oaklands Manor Dr, Laurel, MD 20708-1430 | 2019-02-26 |
| 1588901946 | Mary Nongndeh Zelio | Nurse Practitioner | 3573 Fort Meade Rd, Laurel, MD 20724-2015 | 2013-01-04 |
| 1093075731 | Nadine Carole Missiet Fogoum | Nurse Practitioner | 8625 Savannah River Rd, Laurel, MD 20724-1956 | 2012-05-28 |
| 1649573346 | Leighton Kennedy | Nurse Practitioner | 8101 Sandy Spring Rd Ste 250, Laurel, MD 20707-3527 | 2010-12-19 |
| 1780816553 | Janet Powell Mcmillan | Nurse Practitioner | 69 Watertank Rd, Laurel, MS 39443-2954 | 2009-08-12 |
| 1487260584 | Rose Godwin Support Services, Inc | Nurse Practitioner | 13671 Baltimore Ave, Laurel, MD 20707-5096 | 2020-09-23 |
| 1548871106 | Muni Gwanyebit | Nurse Practitioner | 13994 Baltimore Ave Ste 102, Laurel, MD 20707-5087 | 2020-08-16 |
| Find all providers in LAUREL | ||||
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| 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.