Healthcare Provider Details

I. General information

NPI: 1952089724
Provider Name (Legal Business Name): MOUNTAIN VIEW THERAPEUTIC WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3703 N ROLLING RD APT D
BALTIMORE MD
21244-3346
US

IV. Provider business mailing address

3703 N ROLLING RD APT D
WINDSOR MILL MD
21244-3346
US

V. Phone/Fax

Practice location:
  • Phone: 410-705-0949
  • Fax:
Mailing address:
  • Phone: 410-705-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KISHMA M TROTMAN
Title or Position: OWNER/THERAPIST
Credential: LCSW-C
Phone: 410-705-0949