Healthcare Provider Details

I. General information

NPI: 1821928268
Provider Name (Legal Business Name): GENESIS WELLNESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 E OLIVER ST
BALTIMORE MD
21213-3915
US

IV. Provider business mailing address

4510 PRIMROSE FOLLY CT
BOWIE MD
20720-5003
US

V. Phone/Fax

Practice location:
  • Phone: 240-687-0890
  • Fax:
Mailing address:
  • Phone: 240-687-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERYL ANN NEVERSON
Title or Position: CEO
Credential: PH.D., LICSW, LCSW-C
Phone: 240-687-0890