HEALTH RELEAF LLC NPI 1770255291

NPI Information

NPI: 1770255291
Provider Name: HEALTH RELEAF LLC
Classification: Nurse Practitioner - 363LP0808X
Specialization: Psychiatric/Mental Health
Entity Type: Organization
Doing Business As: SELF
CLIA Number: 21D2152922
Address: 1406B CRAIN HWY S STE 304
GLEN BURNIE, MD
ZIP 21061
Phone: (301) 804-0344

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NPI Details

HEALTH RELEAF LLC is a psychiatric/mental health nurse practitioner in Glen Burnie, MD. HEALTH RELEAF LLC NPI is 1770255291. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Self.

The provider's business location address is:

1406B CRAIN HWY S STE 304
GLEN BURNIE, MD
ZIP 21061-094
Phone: (301) 804-0344

The provider's authorized official is Donna Boatman .
The authorized official title is Credentialing Manager and has the following contact phone number (301) 399-6874.

The CLIA number assigned to this NPI record is 21D2152922 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2021 and was last updated on 12/19/2022.

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
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	633004500	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: 11/21/2025

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