CERVELLO-WELLNESS LLC NPI 1083239255

NPI Information

NPI: 1083239255
Provider Name: CERVELLO-WELLNESS, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
11810 GRAND PARK AVE STE 500
NORTH BETHESDA, MD
ZIP 20852
Phone: (301) 392-7120
Get Directions

CERVELLO-WELLNESS, LLC is a psychiatric/mental health nurse practitioner in North Bethesda, MD. CERVELLO-WELLNESS, LLC NPI is 1083239255. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11810 GRAND PARK AVE STE 500
NORTH BETHESDA, MD
ZIP 20852-679
Phone: (301) 392-7120

The provider's authorized official is Mimi Tyson .
The authorized official title is Psychiatric Nurse Practitioner and has the following contact phone number (301) 392-7120.

The enumeration date for this NPI number is 6/12/2020 and was last updated on 4/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	521090900	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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