MEDICARE: PRETTY WOMEN THAT PRAY FOUNDATION PWP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1518808088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRETTY WOMEN THAT PRAY FOUNDATION PWP

Provider Business Mailing Address
First Line	:	14 BANTRY CT
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3448
Country	:	US
Telephone Number	:	202-569-4966
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 BANTRY CT
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3448
Country	:	US
Telephone Number	:	202-569-4966
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OF STAFF
Name	:	RHONECE FORD
Credential	:
Telephone Number	:	202-763-8603

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/08/2026

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