Healthcare Provider Details

I. General information

NPI: 1679428254
Provider Name (Legal Business Name): WILLING TO ASSIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 EASTERN BLVD
BALTIMORE MD
21221-3438
US

IV. Provider business mailing address

1546 EASTERN BLVD
BALTIMORE MD
21221-3438
US

V. Phone/Fax

Practice location:
  • Phone: 443-815-8126
  • Fax: 443-815-8126
Mailing address:
  • Phone: 443-815-8126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: VERCELL SANTONIA BAYLOR
Title or Position: BUSSINESS OWNER
Credential: CNA
Phone: 443-815-8126