WELLNESS SOURCE LLC NPI 1114420320

NPI Information

  • NPI: 1114420320
  • Provider Name: WELLNESS SOURCE LLC
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Organization
  • Doing Business As: YOUR WELLNESS SOURCES
  • Address: 4301 GARDEN CITY DR STE 304
    HYATTSVILLE, MD
    ZIP 20785
  • Phone: (301) 235-0060

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NPI Details

WELLNESS SOURCE LLC is a dietitian registered in Hyattsville, MD. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. WELLNESS SOURCE LLC NPI is 1114420320. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Your Wellness Sources.

The provider's business location address is:

4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
ZIP 20785-105
Phone: (301) 235-0060

The provider's authorized official is Marshalee George .
The authorized official title is Medical Director and has the following contact phone number (301) 235-0060.

The enumeration date for this NPI number is 3/14/2018 and was last updated on 5/4/2022.

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
1133VN1006XDietitian, RegisteredNutrition, MetabolicNo
2133VN1201XDietitian, RegisteredNutrition, Obesity and Weight ManagementNo
3163WP0807XRegistered NursePsychiatric/Mental Health, Child & AdolescentNo
4163WP0808XRegistered NursePsychiatric/Mental HealthNo
5207RA0401XInternal MedicineAddiction MedicineNo
6363LA2200XNurse PractitionerAdult HealthNo
7363LF0000XNurse PractitionerFamilyNo
8363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
9363LW0102XNurse PractitionerWomen's HealthNo
10133V00000XDietitian, RegisteredYes

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: 11/21/2025

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