SELF REALIZATION, LLC (NPI# 1487982880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487982880 |
| Entity Type | Organization |
| Organization Name | SELF REALIZATION, LLC |
| Other Organization Name | WISDOM COUNSELING |
| Practice Address |
102 Sleepy Hollow Dr Ste 200 Middletown DE 19709-5841 |
| Mailing Address |
9 Morning Dew Dr Middletown DE 19709-2419 |
| Practice Telephone | 3023128221 |
| Mailing Telephone | 3023128221 |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2010-02-04 |
| Authorized Official Name | DR. EARL WALKER JR. (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3023128221 |
| Authorized Official Credential | ED.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
B10000757 | DE | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Wisdom Counseling | Doing Business As Name - Organization |
| Street Address |
102 SLEEPY HOLLOW DR STE 200 |
| City | MIDDLETOWN |
| State | DE |
| Zip Code | 19709-5841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344816 | Rodrigo Cordero Tanchanco | Internal Medicine | 102 Sleepy Hollow Dr, Suite 101, Middletown, DE 19709-5841 | 2005-05-27 |
| 1407274046 | Mani Thomas | Counselor | 102 Sleepy Hollow Dr, Child Guidance Resource Centers, Middletown, DE 19709-5841 | 2014-04-01 |
| 1053732883 | Pittman Behavioral Health LLC | Clinic/Center | 102 Sleepy Hollow Dr, Suite 204 Bunker Hill Building, Middletown, DE 19709-5841 | 2013-12-20 |
| 1417380312 | Taresa Pittman | Registered Nurse | 102 Sleepy Hollow Dr, Suite 204 Bunker Hill Building, Middletown, DE 19709-5846 | 2013-08-14 |
| 1356693394 | First State Internal Medicine PC | Clinic/Center | 102 Sleepy Hollow Dr, Suite 101, Middletown, DE 19709-5841 | 2012-10-14 |
| 1053604595 | Cheryl Seaman Sadeghee | Social Worker | 102 Sleepy Hollow Dr, Suite 200, Middletown, DE 19709-5841 | 2011-05-17 |
| 1275837189 | Ana Nora Caruso | Social Worker | 102 Sleepy Hollow Dr, Suite 103, Middletown, DE 19709-5841 | 2011-01-06 |
| 1962733436 | Ladale Renee Walker | Dietitian, Registered | 102 Sleepy Hollow Dr, Suite 200, Middletown, DE 19709-5841 | 2010-01-24 |
| 1437383395 | Jolly Smiles, P.a. | Dentist | 102 Sleepy Hollow Dr, Suite 100, Middletown, DE 19709-5841 | 2009-05-06 |
| 1871716423 | Mary Dale | Counselor | 102 Sleepy Hollow Dr, Middletown, DE 19709-5841 | 2007-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285249797 | Lucinda M Cadet | Social Worker | 600 N. Broad Street, Suite 5, #768, Middletown, DE 19709 | 2020-09-11 |
| 1447870118 | Adella Sangarie | Licensed Practical Nurse | 712 Wood Duck Ct, Middletown, DE 19709 | 2020-04-22 |
| 1336600535 | Nathan Lo | Student in an Organized Health Care Education/Training Program | 937 Whispering Trail, Middletown, DE 19709 | 2019-03-29 |
| 1629559554 | Acceptance Counseling, LLC | Social Worker | 115 N. Broad St, Ste 1, Middletown, DE 19709 | 2018-08-28 |
| 1356844492 | Eden Hill Expresscare, LLC | Clinic/Center | 749 Middletown Warwick Road, Middletown, DE 19709 | 2018-03-15 |
| 1740782135 | Angela L Robinson | Counselor | 5350 Summit Bridge Rd Ste 103, Middletown, DE 19709 | 2018-03-02 |
| 1417456492 | Metanoia Counseling, LLC | Clinic/Center | 101 West Park Place, Middletown, DE 19709 | 2018-02-06 |
| 1275031114 | Nicole Brody Gomes | Physical Therapist | 210 Cleaver Farms Rd, Ste 1, Middletown, DE 19709 | 2018-01-25 |
| 1972012383 | Raymond Robert Solinger | Physical Therapist | 210 Cleaver Farms Rd Ste 1, Middletown, DE 19709 | 2017-09-28 |
| 1811432008 | Leslie Nkansah | Pharmacist | 367 Ellenwood Drive, Middletown, DE 19709 | 2016-12-27 |
| Find all providers in zip 19709 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689733792 | Connections Community Support Programs, Inc. | Psychologist | 3821 Lancaster Pike, Wilmington, DE 19805-1512 | 2006-12-06 |
| 1306918180 | State of Delaware | Psychologist | 417 Federal St, Dover, DE 19901-3635 | 2006-11-15 |
| 1215009097 | State of Delaware | Psychologist | 417 Federal St, Dover, DE 19901-3635 | 2006-11-15 |
| City | MIDDLETOWN |
| Zip Code | 19709 |
Please comment or provide details below to improve the information on SELF REALIZATION, LLC.
| 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.